Antidotes lesions

Some members of this group (e.g., EPTQ have anticholinesterase activity. Signs are anor a, we ht loss, diarrhea, ataxia, muscle tremors, salivation, artd bloating. Atropine may be used cautiously as an antidote. Lesions are nonspecific congestion of the intestinal tract and other organs. 

There is no antidote for exposure to these agents. Treatment consists of symptomatic management of lesions. Eye lesions should be treated by saline irrigation and coating the follicular margins with petroleum jelly to prevent sticking. 

Antidotes British Anti-Lewisite (BAL) can be given by intramuscular injection as an antidote for systemic effects but has no effect on the local lesions of the skin, eyes, or airways. Treatment consists primarily of supportive care. 

Treatment — Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.2. No antidotes are known. Treatment consists of symptomatic management of lesions. If a patient inhaled HD but does not display symptoms of an impacted airway, it may still be appropriate to intubate him because laryngeal spasms or edema may make it difficult or impossible later.2... 

ECG abnormalities in children who ingested castor beans have been noted by Kaszas and Papp (1960). These include QT interval lengthening, repolarization changes, and intraventricular conduction disturbances. Crompton (1980) later reported on experiments on pigs that experienced hemorrhagic lesions and an abnormal ECG due to ricin. At the present time, no antidotes or effective therapy are available to counteract the effects of ricin. 

Solhnann, T. (1919). Dichlorethylsulphide ( mustard gas ) I. The influence of solvents, absorbents and chemical antidotes on the severity of the human skin lesions. J. Pharmacol. Exp. Ther. 12 303-18. 

Vinca alkaloids are potential vesicants (76-78) and accidental drug extravasation can cause severe soft tissue ulceration. The initial symptoms include marked pain, erythema, and local swelling for several hours up to a day later effects include blisters and severe painful skin ulcers, several days and 3 weeks after extravasation respectively. The lesions usually heal very slowly and sometimes require surgical intervention. Because vinca alkaloid extravasation can have severe effects, the use of antidotes is highly recommended when extravasation is suspected. In addition, venous irritation can be worsened if the vinca alkaloid is infused over at least 20-30 minutes rather than 6-10 minutes. 

British antilewisite (BAL) or dimercaprol was developed as an antidote for lewisite. It is used in medicine as a chelating agent for heavy metals. Although BAL can cause toxicity itself, evidence suggests that BAL in oil administered intramuscularly will reduce the systemic effects of lewisite. BAL skin and ophthalmic ointment decrease the severity of skin and eye lesions when applied immediately after early decontamination, but neither of these ointments is currently manufactured. 

The second exception is that while an antidote is available for systemic effects of Lewisite exposure, there are no antidotes for nitrogen mustard or sulfur mustard toxicity, with one minor caveat if given within minutes after exposure, intravenous sodium thiosulfate may prevent death due to sulfur mustard exposure (25). Otherwise, the medical management for skin, ocular, and respiratory exposure is only supportive. One guideline physicians can follow is to keep skin, eye, and airway lesions free from infection. 

Immediate decontamination of any exposure is essential. Symptomahc management of lesions with administration of antidote for treatment of systemic effects. 

It has been shown in an experimental guinea pig model that CuZnSOD and MnSOD are effective in treatment of mustard gas burns. Mustard gas, used as a warfare since World War I, causes blistering lesions that are slow to heal, and secondary inflammation. There is no antidote for burns by mustard gas. SODs were foimd to effectively reduce the burn lesion area when administered in-traperitoneally/intralesionally [260]. 

F. Treatment of Lewisite Lesions. The treatment of lewisite lesions is detailed in Chapter 3 of FM 8-9 (Part III). An antidote for lewisite is dimercaprol, BAL (British Anti Lewisite). However, the toxicity of dimercaprol itself must be considered. It sometimes provokes local irritation. 

The only reported antidote for domoic acid toxicity was described in a series of papers published shortly after the 1987 PEI disaster. These studies by Glavin, Pinsky and colleagues indicated that kynurenic acid, a broad-spectrum excitatory amino acid (EAA) antagonist which is actually present in the brain in small amounts, would reduce both behavioural toxicity and gastrointestinal lesions when administered 45 or 75 minutes after domoic acid in mice. Unfortunately very high doses were required (300 and 600 mg/ kg) and the time frame for the effect was fairly narrow. For these and other reasons kynurenic acid has little potential as a human medication. Nonetheless, the potential for developing such a drug still exists. 

An antidote is available for lewisite exposure. BAL (British-Anti-Lewisite dimercaprol) was developed by the British during World War II. The antidote is produced in oil diluent for intramuscular administration to counter the systemic effects of lewisite. There is no effect, however, on the skin lesions (eyes, skin, and respiratory system) from the antidote. Mustard agents (H), (HD), (HS), and (HT), like nerve agents, would be classihed as Class 6.1 poisons by the DOT and would have NFPA 704 designations of health 4, flammability 1, reactivity 1, and special... 

Dekleva, A., D. Sket, J. Sketelji, and M. Brzin. 1989. Attenuation of soman- induced lesions of skeletal muscle by acetylcholinesterase reactivating and nonreactivating antidotes. Acta Neu-ropathol. 79(2) 183 -89 cited in Chem. Abstr. CA 112(1) 93434p. 

Medical personnel should follow the same principles for managing Lewisite skin, eye, and airway lesions that they follow for managing mustard lesions. A specific antidote, BAL (dimercaprol), will prevent or greatly decrease the severity of skin and eye lesions if applied topically within minutes after the exposure and decontamination (however, preparations of BAL for use in the eyes and on the skin are no longer available). Given intramuscularly, BAL will reduce the severity of systemic effects. BAL binds to the arsenic of... 

Phosgene oxime (dichloroformoxime) is a colorless crystalline solid with a melting point of approximately 37.7°C (100°F). In liquid or vapor form it is highly corrosive, and it penetrates clothing and mbber readily. The mechanism by which it damages tissue is unknown, but its effects are almost instantaneous and produce severe pain. Skin lesions are like those caused by a strong acid. There is no antidote treatment will be similar to that for mustard. 

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