Flaccid skin

Skin and fur Color, turgor, integrity Reddening, flaccid skinfold,... 

Overdosage results in severe respiratory depression, skeletal muscle flaccidity, bronchospasm, cardiovascular disturbances, such as CHF, hypotension or hypertension, arrhythmias, cold and clammy skin, cyanosis, and coma. 

Hyperkalemia may occur as a result of digitalis toxicity. Signs and symptoms of hyperkalemia include diarrhea, paresthesia of extremities, heaviness of legs, decreased BP, cold skin, grayish pallor, hypotension, mental confusion, irritability, flaccid paralysis, tented T waves, widening QRS interval, and ST depression. 

Severe dermal exposure Sudden coma, seizures, flaccid paralysis with apnea, miosis, diarrhea, and a victim who is wet (lacrimation, salivation, urination, sweating, copious upper and lower respiratory secretions). Onset of symptoms may be delayed by 30 minutes following exposure as the agents transit the skin. 

The G agents present a vapor hazard as they are very volatile. VX has a high dermal toxicity, even through intact skin, as the liquid does not evaporate quickly (Berkenstadt et al, 1991 Sidell et al, 1997). VX is 300 times more toxic than tabun on skin. A very small drop on the skin may cause sweating and fasciculations at the site. A larger dermal drop may cause loss of consciousness, seizures, apnea, and flaccid paralysis. Toxicity in descending order, on a per weight basis, is VX > soman > sarin > tabun (HSDB, 2008). 

ACGIH TLV TWA 0.05 mg/m (skin) Not Classifiable as a Human Carcinogen SAFETY PROFILE Poison by ingestion, skin contact, and intraperitoneal routes. Human systemic effects by ingestion flaccid paralysis without anesthesia, motor activity changes, fever, and inhibition of cholinesterase. When heated to decomposition it emits highly toxic fumes of SOx and POx. See also PARATHION. 

SAFETY PROFILE A deadly human poison by skin contact and inhalation. (A small drop on the skin can kill a man.) A deadly experimental poison by ingestion, inhalation, skin contact, subcutaneous, intravenous, intramuscular, and intraperitoneal routes. Human systemic effects muscle weakness, bronchiolar constriction, nausea or vomiting, flaccid paralysis without anesthesia, miosis (pupOlar constriction), cholinesterase inhibition. A nerve gas used as a chemical warfare agent. To fight fire, use foam, CO2, drj chemical. When heated to decomposition or reacted with steam, it emits very toxic fumes of F and PO.. See also PARATHION. 

Paregoric produces CNS depression ranging from drowsiness to coma. These symptoms can be cyclic due to decreased gastric emptying. Respiratory depression occurs and progresses to Cheyne-Stokes respirations, cyanosis, and respiratory arrest. Pulmonary edema can also occur. Cardiac affects are characterized by bradycardia and hypotension. Other symptoms include hypothermia, flaccid skeletal muscles, cold and clammy skin. 

Overdosage results in respiratory depression, skeletal muscle flaccidity, cold clammy skin, cyanosis, extreme somnolence progressing to convulsions, stupor, coma. Tolerance to analgesic effect, physical dependence may occur with repeated use. Prolonged duration of action, cumulative effect may occur in those with impaired hepatic and renal function. 

Characterized by thin-walled, easily ruptured, flaccid bullae that are seen to arise on normal or erythematous skin and over mucous membranes, the lesions of PV appear initially in the mouth (in about 60% of the cases) and then spread, after weeks or months, to involve the axillae and groin, scalp, face and neck. The lesions may become generalized. 

In acute dermal studies by Carpenter et al. (1956), extreme congestion of the kidney, hemoglobinuria, pale liver, and engorged spleen were noted in the rabbits that died. Deaths occurred at dose levels of 403-1,804 mg/kg for undiluted 2-butoxyethanol. In New Zealand rabbits of unspecified sex to which 250, 500, 1,000 or 2,000 mg/kg 2-butoxyethanol was applied to clipped, abraded skin and occluded for 24 hours, 1 of 4 died at 500 mg/kg on day 12, and 10 of 10 died at 1,000 and 2,000 mg/kg on days 1-2 (Olin 1976). At 24 hours, rabbits exposed to 1,000 mg/kg/day exhibited flaccid muscle tone and hematuria, whereas rabbits exposed to 2,000 mg/kg/day exhibited lacrimation, hematuria, flaccid muscle tone, and anorexia (Olin 1976). No treatment-related deaths occurred in male or female New Zealand rabbits to which doses of 361 mg/kg/day were applied to the clipped, occluded skin for 6 hours per day for nine applications over 11 days (Union Carbide 1980a). 

Musculoskeletal Effects. Flaccid muscle tone, probably neurological in origin, was observed prior to death in rabbits dosed with 1,000 or 2,000 mg/kg 2-butoxyethanol on abraded, occluded skin for 24 hours (Olin 1976). Histological examination of skeletal muscle and bone (sternum) revealed no lesions in male or female New Zealand rabbits dosed with up to 150 mg/kg/day 2-butoxyethanol 6 hours per day, 5 days per week, for 90 days (CMA 1983). 

Polyneuritis, tremors, paresthesias of hands and feet, retrobulbar neuritis, painful extremities, cranial nerve palsies, optic neuropathy, flaccid paralysis, choreiform movements, myoclonic movements of head and extremities, sensory neuropathy, ascending weakness, optic neuritis and blindness, abnormal reflexes, Babinski s reflex, residual weakness, visual problems Skin eruptions, hepatorenal injury, bone marrow depression, alopecia, hypertension, achlorhydria, stomatitis, excessive salivation, gingival discoloration, tachycardia, arrhythmias, weakness... 

She was treated with oxamniquine and transported to the USA, where evaluation showed flaccid paralysis and decreased sensation of touch and of temperature over the skin of the legs. Cerebrospinal fluid examination showed pleocytosis and protein elevation. Serologic tests for mycoplasma and viral pathogens were negative. A myelogram. showed no masses amenable to surgical removal. 

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