Mustard central nervous system effects

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. 

Obviously, these findings confirm the theoretical assumption that the lipophilic properties of sulfur mustard result in a distribution, primarily in lipophilic tissues. High concentrations found in the brain may also explain why the central nervous system is one of the organs exhibiting systemic effects of sulfur mustard poisoning, even though it is not a site of rapidly proliferating cells. 

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). 

---