Medical Defense Against Nerve Agents: New Directions

Rickett, Daniel J.; Glenn, John F.; Houston, William E.

doi:10.1093/milmed/152.1.35

Cited by 27 publications

(14 citation statements)

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“…VX is easily absorbed through the skin and generally does not have a major inhalation hazard in the zone [1,43]. Overall relative lethality of NAs in animal studies is: VX>Soman>Sarin>Tabun [45]. …”

Section: Relative Toxicitymentioning

confidence: 99%

Advances in toxicology and medical treatment of chemical warfare nerve agents

2012

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Organophosphorous (OP) Nerve agents (NAs) are known as the deadliest chemical warfare agents. They are divided into two classes of G and V agents. Most of them are liquid at room temperature. NAs chemical structures and mechanisms of actions are similar to OP pesticides, but their toxicities are higher than these compounds. The main mechanism of action is irreversible inhibition of Acetyl Choline Esterase (AChE) resulting in accumulation of toxic levels of acetylcholine (ACh) at the synaptic junctions and thus induces muscarinic and nicotinic receptors stimulation. However, other mechanisms have recently been described. Central nervous system (CNS) depression particularly on respiratory and vasomotor centers may induce respiratory failure and cardiac arrest. Intermediate syndrome after NAs exposure is less common than OP pesticides poisoning. There are four approaches to detect exposure to NAs in biological samples: (I) AChE activity measurement, (II) Determination of hydrolysis products in plasma and urine, (III) Fluoride reactivation of phosphylated binding sites and (IV) Mass spectrometric determination of cholinesterase adducts. The clinical manifestations are similar to OP pesticides poisoning, but with more severity and fatalities. The management should be started as soon as possible. The victims should immediately be removed from the field and treatment is commenced with auto-injector antidotes (atropine and oximes) such as MARK I kit. A 0.5% hypochlorite solution as well as novel products like M291 Resin kit, G117H and Phosphotriesterase isolated from soil bacterias, are now available for decontamination of NAs. Atropine and oximes are the well known antidotes that should be infused as clinically indicated. However, some new adjuvant and additional treatment such as magnesium sulfate, sodium bicarbonate, gacyclidine, benactyzine, tezampanel, hemoperfusion, antioxidants and bioscavengers have recently been used for OP NAs poisoning.

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Section: Relative Toxicitymentioning

confidence: 99%

Advances in toxicology and medical treatment of chemical warfare nerve agents

2012

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“…26 Pode-se, então, destacar três níveis de defesa contra armas químicas: detecção e/ou descontaminação da área exposta ao agente tóxico, evitando contato indireto do mesmo com os indivíduos; proteção individual e/ou coletiva para evitar o contato direto com o agente tóxico, caso seja necessário entrar em uma área exposta e, tratamento médico especializado, caso haja contato com o agente tóxico.…”

Section: Defesa Químicaunclassified

Defesa química: histórico, classificação dos agentes de guerra e ação dos neurotóxicos

Silva¹,

Borges²,

Figueroa‐Villar³

et al. 2012

Quím. Nova

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“…A ccording to Somani et al (1992), the direct action of nerve agents on nicotinic and muscarinic ACh receptors may occu r when concen trations in the blood rise above m icromolar levels, whereas at lower levels the action is mainly the result of inhibition of AChE. VX may also counteract the effects of ACh by acting as an open chan nel blocker at the neuromuscular junction, thereby interrupting neuromuscular function (Rickett et al, 1987). VX "m ay directly affect a small population of musca rinic ACh rece ptors that have a high affinity for [ 3 H ]-cis-m ethyldioxalane binding" (Som ani et al, 1992).…”

Section: Effects Of Organophosphate Agents On the Nervous Systemmentioning

confidence: 99%

Appendix A: Health Risk Assessment for the Nerve Agent Ga

2000

Journal of Toxicology and Environmental Health

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This H ealth Risk Assessm ent for the N erve Agent G A is a draft report from Sep tem ber 1996 (editorial corre ctions m ade April 1997), prep ared for the U .S. D epartm ent of the Arm y, Arm y Environmental Center under In tera ge ncy A gree m e n t 1 7 6 9 -1 7 6 9 -A 1 , p rep are d by th e Life S cie n ces D ivision of O ak Ridge N ational Laboratory (manage d by Lockheed M artin Energ y Research Corp. for the U .S. D epartm ent of Energy under contract D E-AC05-96O R22464), O ak Ridge, TN . It was subm itted to the M aterial/ Ch em ical Risk Assessm en t W orkin g G rou p Advisory an d C oo rd inating Comm ittee, Environm ental Risk Assessm ent Program.This docum ent is an internal review draft for rev iew p urposes on ly and does not constitute U .S. gove rnm ent policy. M ention of trade nam es or com m erc ial products does not constitute endorsem ent or rec omm endation for use. PREFACETh is re po rt a ssesses th e po te ntia l n o nc an cer an d can cer e ffects o f chemical agent G A (CAS no. 77-81-6). This docum ent supp orts the activities of the M aterial/Ch em ical Risk Assessm ent Working Group of the Enviro nmental Risk Assessm ent Program , a co op erative en de avor o f the D ep artm en t o f D efense , D e partm en t o f Energ y, and U .S. Environm ental Protection Agency. This w orking gro up is developing toxicity values for selected chem icals of concern at federal facilities. Toxicity values w ill be subm itted for consideration by the U .S. EPA's IRIS Consensus Process for inclusion on IRIS (EPA's Integra ted Risk Info rm ation System ). The M aterial/Ch em ic al Risk A ssessm ent Wo rking G roup consists of D rs. Jim Cogliano (chair) and H arlal Choudhury (U .S. EPA ); D r. Bruce Briggs (Geo-Centers); Lt. C mdr. Warre n Jederberg and D r. Robert L. Carp enter (U .S. N aval M edical Research Institute); D r. Elizabeth M aull an d John H inz (U .S. A ir Force O ccup ation al and Environ m ental H ealth D irectorate); D rs. G len n Leach and W inn ie Palm er (U .S. A rm y Center for H ealth Promotion and Preven tive M edicine); and D rs. Robert Young and Po-Yung Lu (O ak Ridge N ational Lab oratory ). This document w as w ritten by D r. D ennis M . O presko, Life Sciences D ivision, Oak Ridge N ational Laboratory, O ak Ridge, TN . Internal peer rev ie w w as p rov id ed b y D r. R o b e rt Yo u n g , D r. A n n e tta W atso n , a n d Rob ert Ro ss. Ex tern al review o f th e toxicity data w as p rovid ed by D r. Thom as J. Bucci, Integra ted Services, W hite H all, AR, and D r. I. K. H o of the U niversity of M ississippi M edical Center, Jackson , M S. External rev iew of the derivat ion of the RfD s was provided by D rs. M ichael D ourson and Air The vap or pressure for G A is 0.07 m m H g at 25°C, indicating a moderate potential for volatilization. A vapor concentration of 610 mg/m 3 362 O AK RIDG E N ATIO NAL LA BO RATO RY has b een rep orted fo r a te m p erature of 25°C (U .S. D e partm en t o f the Arm y, 1974 ). (Althou gh no t ad eq uately d escribed in the reference, this presum ...

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Medical Defense Against Nerve Agents: New Directions

Cited by 27 publications

References 0 publications

Advances in toxicology and medical treatment of chemical warfare nerve agents

Advances in toxicology and medical treatment of chemical warfare nerve agents

Defesa química: histórico, classificação dos agentes de guerra e ação dos neurotóxicos

Appendix A: Health Risk Assessment for the Nerve Agent Ga

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