Soman atropine

Sket, D., Brzin, M., Vreca, I. (1989). Effect of HI-6 and diazepam on the increase of creatine kinase isoenzymes activity in plasma of atropinized, soman-poisoned rats. Acta Pharm, Jugoslav. 39 151-9. 

H-oximes used in combination with atropine sulfate against a background of the intramuscular or inhalation administration of soman are able to protect animals (dogs, monkeys) from 4-5 DL50 of this poison [9],... 

High therapeutic effect was received with the usage of atropine (10 mg/kg, i.m.) and carboxime (30 mg/kg, i.m.) in animals poisoned with sarin, soman and VX. 

Drug solutions and implantation of osmotic mini-pumps Physostigmine hemisulphate and procyclidine hydrochlorid were obtained from Sigma (St.Louis, U.S.A.), scopolamine hydrobromid from Merck (Darmstadt, Germany), atropine sulphate was obtained from ACF (Amsterdam, The Netherlands), and diazepam from Roche (The Netherlands). HI-6 was made available by the Defence Research Establishment, Suffield, Canada. Soman (O-pinacolyl methylphosphonofluoridate) was synthesised at TNO. Alzet Osmotic Mini-pumps with a constant delivery rate of 0.55 pl/hr (Model 2002, Alza Corp., Palo Alto, USA) were used to deliver PYR, PHY and SCO. The vehicle consisted of 20% propylene glycol, 10% ethanol and 70% water. The pumps were implanted subcutaneously under isoflurane/02 inhalation anesthesia. 

Nerve Agent Antidote Kit (NAAK or MARK I) consists of an atropine auto-injector (2 mg), a pralidoxime chloride auto-injector (2-Pam-Cl, 600 mg), the plastic clip joining the two injectors, and a foam case. The kit serve as a countermeasure to nerve agents, including tabun (GA), sarin (GB), soman (GD), GF, and VX. Military personnel can receive three MARK I for self/buddy aid. Possible side effects of atropine and/or 2-PAM-C1 are deemed insignificant in a nerve agent casualty. Intravenous atropine and 2-PAM-C1 can also be made available. The MARK I kit is manufactured by Survival Technology, Inc., Rockville, Maryland. 

Carter, W.H., Jr., Jones, D.E., and Carchman, R.A. (1985), Application of Response Surface Methods for Evaluating the Interactions of Soman, Atropine, and Pralidioxime Chloride, Fundamental and Applied Tox., 5, S232-S241. 

Berry WK, Davies DR, Gordon JJ. Protection of animals against soman (1,2,2-trimethylpropyl methylpho-sphono-fluoridate) by pretreatment with some other organophosphorus compounds, followed by oxime and atropine. Biochem. Pharmacol., 1971, 20(1), 125-134. 

Lallement, G., Masqueliez, C., Baubichon, D. et al. (2004). Protection against soman-induced lethality of the antidote combination atropine-pralidoxime pro-diazepam packed as freeze-dried form. J. Med. Chem. 2 1-11. 

Clinton, M.E., Misulis, K.E., Dettbam, W-D. (1988). Effects of phenytoin, ketamine, and atropine methyl nitrate in preventing neuromuscular toxicity of acetylcholinesterase inhibitors soman and diisopropylphosphorofluoridate. J. Toxicol. Environ. Health 24 439-49. 

Gupta, R.C., Dettbam, W-D. (1992). Potential of memantine, d-tubocurarine and atropine in preventing acute toxic myopathy induced by organophosphate nerve agents soman, sarin, tabun and VX. NeuroToxicology 13 500-14. 

Carpentier, P., Foquin, A., Rondouin, G., LemerNatoli, M., deCroot D.M.G., Lallement, G. (2000). Effects of atropine sulphate on seizure activity and hrain damage produced by soman in guinea-pigs ECoG correlates of neuropathology. 

McDonough, J.H., Jaax, N.K., Crowley, R.A., Mays, M.Z., Modrow, H.E. (1989). Atropine and/or diazepam therapy protects against soman-induced neural and cardiac pathology. Fundam. Appl. Toxicol. 13 256-76. 

Delayed peripheral neurotoxicity has been reported in animal studies. Soman produced severe delayed neuropathy in the atropinized hen assay at 1.5 mg/kg (Willems et al. 

Autoinjectors (AtroPen , Mark I , Combopen MC ) are atropine or atropine and pralidoxime combinations available for human use. They are not used in veterinary medicine as they are not adjustable for different sized patients. Experimental vaccines against nerve agent VX, and monoclonal antibodies which protect against soman, sarin, and tabun toxicity have been produced and are being tested (Dunn and Sidell, 1989 Somani et al, 1992). 

Langenberg, J.P., Spruit, H.E.T., Van der Wiel, H.J., Trap, H.C., Helmich, R.B., Bergers, W.W.A., Vanhelden, H.P.M., Benschop, H.P. (1998a). Inhalation toxicokinetics of soman stereoisomers in the atropinized guinea pig with nose-only exposure to soman vapor. Toxicol. Appl. Pharmacol. 151 79-87. 

Standard post-exposure treatments include eoneurrent administration of anticholinergics, such as the musearinie cholinergic blocker atropine sulfate, and AChE reactivators, such as obidoxime and pyridine-2-aldoxime methochloride (also known as 2-PAM). Oximes cannot reactivate OP-inhibited AChE that has already aged . Therefore, traditional oxime treatment is considered to be less effective for those agents such as soman, for which aging is rapid (Worek et al, 2005). 

Dorandeu, F., Carpentier, P., Baubichon, D., Four, E., Bemabe, D., Burckhart, M., Lallement, G. (2005). Efficacy of the ketamine-atropine combination in the delayed treatment of soman-induced status epilepticus. Brain Res. 1051(1-2) 164—75. 

X LD50 of soman. When the patch was combined with Hl-6 and atropine injected intramuscularly 1 min after soman exposure, protection was achieved up to a dose of 6 X LD50 (Kim et al, 2005). 

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