Military personnel nerve agent treatment

Exposure to nerve agents requires immediate medical treatment. For this purpose, military personnel are issued with autoinjectors containing countermeasures... 

The UK military combi-pen (autoinjector) contains a combination of atropine (2 mg), pralidoxime (500 mg) and avizafone, a diazepam precursor (equivalent to 5 mg diazepam). Combi-pens are designed to be injected immediately by personnel exposed to, or suffering the symptoms of, nerve agent poisoning according to precise treatment algorithms. 

Medical response, treatment and prevention (prophylaxis) to nerve agent exposure are ever expanding fields of research [6,12,13]. Atropine, which rapidly reverses cholinergic over expression at synapse junctions, is the most commonly used anticholinergic. Mark I kits, which contain 2 mg atropine with an autoinjector for intramuscular use, are issued to US military personnel [2]. Recommended initial field doses for atropine are 2, 4 or 6 mg with re-treatment every 5-10 min depending on the symptoms. In addition, oximes reactivate cholinesterase enzymes, ensuring normal function. Mark I kits also include 600 mg autoinjectors of 2-pralidoxime chloride (2-PAM Cl) with initial field doses of 600, 1200 or... 

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