Mustard agents central nervous system

Notes X = A known adverse effect by an agent CNS = Central nervous system ANS = Autonomic nervous system CV = Cardiovascular system PB = Pyridostigmine bromide OP = Organophosphates CB = Carbamates Pyreth = Pyrethroids Lind = Lindane NA = Nerve agents Mus = Mustard agents Du = Depleted uranium. 

Table 3.6 lists the long-term mustard complications affecting the respiratory tract, the eyes, the skin, the central nervous system and the bone marrow (8,25,26). As alkylating agents, sulfur and nitrogen mustards are carcinogens. 

Central nervous system (CNS) toxicity is manifest by nausea and vomiting, particularly after intravenous administration of nitrogen mustard or BCNU. Ifosfamide is the most neurotoxic of these agents, producing altered mental status, coma, generahzed seizures, and cerebellar ataxia. These side effects have been linked to the release of chloroacetaldehyde from the phosphate-linked chloroethyl side chain of ifosfamide. High-dose busulfan may cause seizmes in addition, it accelerates the clearance of phenytoin, an antiseizure medication see Chapter 19). 

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