Lewisite airways

Antidotes British Anti-Lewisite (BAL) can be given by intramuscular injection as an antidote for systemic effects but has no effect on the local lesions of the skin, eyes, or airways. Treatment consists primarily of supportive care. 

Lewisite, a vesicant with HD-Uke properties, causes a similar constellation of signs and symptoms involving the skin, eyes, and airways as well as systemic effects (e.g. increased capillary permeability) after absorption. However, it does not produce immunological suppression like mustard. Another difference is that the management of lewisite toxicity includes an antidote, British Anti-Lewisite (BAL) (Yue/u/.,2003). 

Lewisite is an oily, colorless liquid that can appear amber to black in its impure form. It has the odor of geraniums. It is more volatile than the mustard agents. Lewisite in the air can cause damage to the eyes, skin, and airways by direct contact. Lewisite in water can lead to exposures from drinking the water or from skin contact, and lewisite-contaminated food can be ingested. Lewisite remains as a liquid under a wide range of environmental conditions, from below freezing to very hot temperatures. 

Lewisite effects on the airway are similar to sulfm and nitrogen mustard, except that Lewisite is extremely irritating to the mucus membranes. The immediate, profound irritation of the mucus membranes may drive victims away from the dispersal site, thus helping to limit exposme (8). Exposme to high concentrations of Lewisite results in pulmonary edema (8). 

The second exception is that while an antidote is available for systemic effects of Lewisite exposure, there are no antidotes for nitrogen mustard or sulfur mustard toxicity, with one minor caveat if given within minutes after exposure, intravenous sodium thiosulfate may prevent death due to sulfur mustard exposure (25). Otherwise, the medical management for skin, ocular, and respiratory exposure is only supportive. One guideline physicians can follow is to keep skin, eye, and airway lesions free from infection. 

Lewisite (b-chlorovinyldichloroarsine) is an arsenical vesicant but of secondary importance in the vesicant group of agents. It was synthesized in the early twentieth century and has seen little or no battlefield use (Balali-Mood et al., 2005). Lewisite is similar to mustard in that it damages the skin, eyes, and airways however, it differs from mustard because its clinical effects appear within seconds of exposure. An antidote, British anti-Lewisite (BAL), can ameliorate the effects of Lewisite if used soon after exposure. Lewisite has some advantages over mustard but also some disadvantages. 

Lewisite damages skin, eyes, and airways by direct contact and has systemic effects after absorption. Unlike mustard, it does not produce immunosuppression. Data on human exposure are few. Lewisite was applied to human skin in a few studies however, most information on its clinical effects is based on animal studies (Rovida and Lewisite 1929 Wardell, 1940 Dailey et al., 1941 Buscher and Conway, 1944). 

Lewisite vapor is extremely irritating to the nose and lower airways, causing individuals exposed to it to seek immediate protection, thus limiting further exposure. The airway lesion of Lewisite is very similar to the lesion caused by mustard exposure except that the Lewisite vapor is extremely irritating to the mucous membranes. In large amounts. Lewisite causes pulmonary edema. 

Lewisite damages skin, eyes, and airways by direct contact and has systemic effects after absorption. Unlike mustard, it does not produce immuno-... 

Medical personnel should follow the same principles for managing Lewisite skin, eye, and airway lesions that they follow for managing mustard lesions. A specific antidote, BAL (dimercaprol), will prevent or greatly decrease the severity of skin and eye lesions if applied topically within minutes after the exposure and decontamination (however, preparations of BAL for use in the eyes and on the skin are no longer available). Given intramuscularly, BAL will reduce the severity of systemic effects. BAL binds to the arsenic of... 

If you breathe Lewisite or Mustard-Lewisite vapors, your airways will immediately become irritated. You could experience burning pain in the nose and sinuses, laryngitis, cough, shortness of breath, nausea, and vomiting. You could also experience airway tissue damage and accumulation of fluid in your lungs, which could result in death. 

VESICANT. A substance that causes redness and blisters ( vesicles ), typically on contact with the skin or mucous membranes of the eyes, airways, and lungs. A synonym is blister agent or blistering agent. The sun and certain plants, especially poison ivy, have vesicating properties. Examples of vesicants used for military purposes in chemical weapons (CW) include lewisite, nitrogen mustard, and sulfur mustard. 

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