Antidotes nerve agent poisoning

Baker, M.D. (2007). Antidotes for nerve agent poisoning should we differentiate children from adults Curr. Opin. Pediatr. 19(2) 211-15. 

Clement, J.G., Hansen, A.S., Boulet, C.A. (1992). Efficacy of HL6-7 and pyrimidoxime as antidotes of nerve agent poisoning m mice. Arch. Toxicol. 66 216-19. 

Kuca, K. et al. Strategy for the development of new acetylcholinesterase reactivators—antidotes used for treatment of nerve agent poisonings, Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czech Repub., 149, 429, 2005. 

Atropine an alkaloid obtained from Atropa belladonna. It is used as an antidote for nerve agent poisoning. It inhibits the action of acetylcholine at the muscle junction by binding to acetylcholine receptors. 

Table 5. The antidotal potency and safety ratio of oximes in nerve agent-poisoned rats... 

In symptomatic patients, intravenous access should be established and blood should be taken for measurement of erythrocyte cholinesterase activity to confirm the diagnosis. If the characteristic features of nerve agent poisoning are present, however, antidotal treatment should not be delayed until the result is available. 

No antidote for nerve agent poisoning, or pre-treatment when an attack is likely, is without danger, but faced with a choice between nerve agent poisoning and the side-effects of an antidote, the choice is clear. Untreated recovery can take months before the AChE levels are back to normal. 

There are two sorts of treatment (i) a prophylactic one — something to be taken before a nerve agent attack and (ii) an antidote — something that wiU reverse the effects of nerve agent poisoning, and which would be taken during or after an attack. These forms of treatment have been developed almost entirely with mihtary personnel in mind, that is, fit young men. 

Paddle, B.M. Dowling, M.H. Simple high-performance liquid chromatographic method for assessing the deterioration of atropine-oxime mixtures employed as antidotes in the treatment of nerve agent poisoning. J.Chromatogr, 1993, 648, 373-380... 

A number of novel approaches to the antidotal treatment of OPs have been studied, often using prophylactic protocols and mostly in relation to nerve agent poisoning, but some may be applicable, at least in principle, to OP pesticide poisoning. 

Gray, A. P., R. D. Platz, T. R. Henderson, T. C. P. Chang, K. Takahashi, and K. L. Dretchen. 1988. Approaches to protection against nerve agent poisoning. (Naphthylvinyl) pyridine derivatives as potential antidotes. J. Med. Chem. 87(4) 807-14. 

The principles of treatment of nerve agent poisoning are the same as they are for any toxic substance exposure namely, terminate the exposure establish or maintain ventilation administer an antidote, if one is available and correct cardiovascular abnormalities. 

TABLE 8-1 Potential Antidotes for Nerve Agent Poisoning... 

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