Countermeasures treatment

FIGURE 69.2 Schematic for a PD model of AChE inhibition and aging by OPs such as sarin, together with the interaction of pretrealmenl (pyridostigmine bromide [PB]), and countermeasure treatment (oxime). Pyridostigmine acts as a reversible cholinesterase inhibitor, oxime acts as an AChE regenerator. is an "effective" first-order rate that can be derived as = (fc, [Ox]) /(Kq + [Ox]), when [Ox] [lnhibited... 

As discussed in the introduction, boiler water (BW) treatment programs enable the waterside chemistry of boilers and their associated systems to be controlled within certain agreed upon and relevant parameters and specifications. They provide a countermeasure against a wide range of adverse conditions that may strive to develop and hinder efficient boiler operation or cause serious damage. 

Examines new prophylactic measures and countermeasures to exposure, including antidotes and drugs treatments... 

Take a Second Medication as a Countermeasure. Sometimes despite problematic side effects, it may be necessary that a patient remain on a particular medication. This is a good time to address the risk-benefit approach to side effects. The best comparison is not the side effects associated with a particular medication compared to the lack of side effects without taking the pill it is the side effects of treatment versus the consequences of the untreated disease state. So what if a patient is on a medication that works for them when previous trials have proved unsuccessful, but there is the presence of one or more uncomfortable side effects This does not necessarily leave you powerless to deal with the side effects. One approach is to use a second medication to counteract the side effect of the first medication. One common example of this approach is using anticholinergic medications such as diphenhydramine (Benadryl) or benztropine (Cogentin) to counteract certain side... 

Chronic use of neuroleptics can, on occasion, give rise to hepatic damage associated with cholestasis. A very rare, but dramatic, adverse effect is the malignant neuroleptic syndrome (skeletal muscle rigidity, hyperthermia, stupor) that can end fatally in the absence of intensive countermeasures (including treatment with dantrolene, p. 182). 

Several animal model studies have focused on the immime response to infection and also to vaccination. Most studies identify antibody titer, but some also show cytokine production or possible mechanisms of bacterial evasion. A focus on immime response studies will help to further define B. anthracis pathogenesis and provide insight into the design of future vaccines and therapeutics. Most countermeasure studies have been conducted on vaccines, as antibiotic studies have typically been performed in vitro. Primary concerns are the length of required treatment, effieient prophylaxis methods, and less complicated dosing regimens for vaccines. In a theoretical bioterrorist attack scenario, it will be essential to distribute effective treatment and prophylaxis to infected or potentially exposed persons in an expedient manner. 

The content of this chapter is not inclusive, in the sense of taking one through the complete development and validation of a complex PBPK/PD model, which would describe the kinetics of each component, together with the pharmacodynamic interactions between selected NAs and countermeasures. Rather, this chapter briefly describes some examples of progress made in quantitative modeling and explores how specific countermeasures interfere in this NA-induced cascade of events, and how such quantitative approaches could be used to develop improved treatment regimens. 

Given that multiple countermeasure agents are currently prescribed for NA treatment, and that future therapeutics will likely also involve multidrug combinations, multiple PBPK models can be used to calculate the co-location of specific compounds at specific sites at specific times, where... 

Catalytic bioscavengers will be part of the arsenal of medical countermeasures for prophylaxis and treatments of OP poisoning in the very near future. Next, gene therapy will offer the possibility of transitory production of humanized OP-degrading enzymes in the body. Multiple enzyme associations will be part of active topical skin protectants and decontamination tools. 

FoIIow-up checks It is important to be aware of the pharmacological characteristics of diuretics and to carry out check-ups during diuretic therapy at short intervals, so that countermeasures can be initiated early enough in the event of therapeutic derailment. Intervals between check-ups as well as the diuretic dosage depend on the success of the treatment and the course of disease ... 

The prognosis of cirrhosis caused by toxins (alcohol or medicament abuse, chemical agents, iron storage, etc.) is usually markedly improved by eliminating the causal noxa. Recognition and treatment of secondary immuno-reactions, which may occur concomitantly, are also important. As a result of such reactions, the prognos-tically favourable effect of abstention (e.g. alcohol, pharmacons) may be reduced unless adequate countermeasures with drugs are possible. 

Medical countermeasures. Questions involving operations and policy overlap in this area include these Who—among the military, dependents, contractors, host nationals, and so on—should be vaccinated and under what indemnification agreements When is post-exposure treatment more appropriate ... 

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