A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know

Abstract

While it is unlikely that most medical practitioners will ever encounter nerve agent poisoning, it is critical to be aware of the presenting symptoms and how best to treat patients exposed to these deadly agents. History has shown that rapid medical treatment can easily mean the difference between life and death for a patient in this situation.

Acetylcholinesterase: The “Hub” for Neurodegenerative Diseases and Chemical Weapons Convention

“…Additionally, an efficient "universal antidote' towards all cholinesterase inhibitors is not yet available [198]. To tackle these limitations, development of more lipophilic compounds and novel routes of administration of antidotes have been extensively studied [4,[199][200][201][202][203][204][205].…”

Nerve agents: a guide for emergency nurses. Part 1

“…Nerve agents are chemically related to organophosphate insecticides and are among the most toxic and lethal substances known to mankind (Bailey et al 2014). Therefore, early recognition is vital to manage affected patients safely and effectively and to assure the health and safety of healthcare staff (Candiotti 2017).…”

“…In the acute post-exposure phase excess acetylcholine accumulation is signalled by the production of copious respiratory and oral secretions, gastrointestinal effects including diarrhoea and vomiting, profuse sweating, autonomic instability and generalised muscle weakness that can progress rapidly to paralysis, respiratory arrest and death (Candiotti, 2017). Subsequent to the acute cholinergic effects of nerve agent exposure, survivors may develop an 'intermediate syndrome' (Bailey et al 2014) which can result in appreciable ongoing morbidity characterised by cranial nerve and proximal muscle weakness and respiratory failure.…”

“…Nerve agents affect virtually all body systems (Candiotti 2017). The attributable signs and symptoms can be classified in terms of time of onset, specific nerve receptor (muscarinic or nicotinic) or major body system affected.…”

Composites based on conductive polymer with carbon nanotubes in DMMP gas sensors – an overview

“…The large scale repeated use of nerve agents during the Iran-Iraq war in the 1980s against civilians by Iraqi troops, and during terrorist attacks by the Aum Shinrikyo sect in Japan [14], emphasize the constant threat and urgent Severe pain in exposed area, gastrointestinal distress, vomiting, cardiac arrhythmias need for the development of sensitive and specific diagnostic tools for CWA. In fact, simple synthesis and high toxicity [15] are the major reasons that have led to the significant use of these chemical materials during various wars, for example in Syria 2017, and for individual assassinations -February 2017 in Kuala Lumpur [16][17][18][19].…”