“…After inhalational or cutaneous exposure in humans or animals, absorbed OPNA inhibits the acetylcholinesterase (AChE) enzyme, which controls the hydrolysis of the neurotransmitter acetylcholine. This inhibition causes the accumulation of acetylcholine at the neuromuscular junction that leads to a cholinergic crisis characterized by muscarinic symptoms, including salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis, known by the mnemonic “SLUDGE” [ 2 , 4 , 6 , 7 ]. VX (C 11 H 26 NO 2 PS) is one of the lethal OPNAs, and its median lethal dose (LD 50 ) of percutaneous exposure is less than 10 mg for a 70 kg person [ 5 ].…”