Acute Nerve Agent Poisoning

The implications for treatment are, at this time, uncertain the most logical course would be to avoid convulsions and/or anoxia as much as possible during treatment of acute nerve agent poisoning. 

Acute Exposure If recovery from nerve agent poisoning occurs, it will be complete unless anoxia or convulsions have gone unchecked so long that irreversible central nervous system changes due to anoxemia have occurred. 

Acute side effects occur from therapeutic doses in 1 % of patients. However, an excessive dose of an anticholinesterase drug results in a cholinergic crisis. The condition results from stimulation of muscarinic receptors and depolarization of the motor end plate. Symptoms of salivation, lacrimation, diaphoresis, weakness, and respiratory failure may result. Therapeutic use of pyridostigmine should be discontinued in the presence of nerve agent poisoning, as it may exacerbate symptoms in certain exposures. 

OP poisoning (compared to administration of each alone). Complementary studies should also investigate not only the prophylactic, but also the therapeutic effects of these neuroprotectants. Successful identification of safe and effective neuroprotectants that suppress non-cholinergic activities associated with anti-AChE exposure will provide new pharmacological modalities to protect and treat both the acute and delayed effects of nerve agent poisoning. 

OPs have been in use for several decades as important chemicals for the control of crop pests. With their chemical and biochemical reactions, OPs have been well established as extremely poisonous chemicals. This classification is due to the inhibition of the marker enzyme ChE, which is produced in the liver. Blood enzymes provide an estimate of tissue enzyme activity. After acute exposure to OPs or a nerve agent, the erythrocyte enzyme activity most closely reflects the activity of the tissue enzyme. Once the OPs inhibit the tissue enzyme, it cannot hydrolyze ACh, and the accumulation stimulates the affected organ. Based on the manner of exposure (dose and duration) to different OPs, a series of toxicity signs and symptoms set in the organism, leading to death. These are important aspects to be closely monitored among pest control operators and occupational workers exposed to OPs. 

---