Diazepam sarin poisoning

At the St. Luke s International Hospital, after 9 00 am but before sarin poisoning was clearly suspected, atropine sulfate was administered pal-liatively to treat muscarinic symptoms such as miosis and increased secretion. A total of 515 mg was administered to 640 victims, and while this dose was sufficient, it was considerably lower than the recommended dose in war zones (Okumura et al, 1996,1998b,2005) and may have been related to the fact that the concentration of sarin used in the attack was 35%. The administration of 2-PAM by the St. Luke s hospital at approximately 11 00, appeared to control fasciculation, but the effects associated with sarin poisoning could have been alleviated by time and it is difficult to say whether 2-PAM was therapeutically effective. None of the patients were saved by the use of 2-PAM. In addition to atropine sulfate and 2-PAM, diazepam was used in patients with convulsions. 

Efficacy of the anticonvulsant usage in antidotic formulas depends considerably on OPC type. Thus, index of protection (IP) for the composition of ChR (HI-6 inclusive), cholinolytics and diazepam is much higher for the treatment of intoxication with soman and tabun, than in poisonings with sarin and VX [93],... 

Urbanski, R., Evaluation of the therapeutic effectiveness of optimal doses of atropine sulphate, obidoxime and diazepam in acute poisoning with soman, sarin and VX, Lek. Wojsk., 64,486-490, 1988. 

The clinical experience with the use of 2-PAM iodide, given with atropine and diazepam, in the treatment of the victims of Tokyo sarin attack in 1995 was very favorable (Sidell et al., 2009). However, 2-PAM should not be recommended as the drug of choice for the management of poisoning with all OPs due to its lack of efficacy against tabun and soman. 

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