Nerve agents exposure

Specific information on physical appearance is not available for this material. This material is a degradation product from hydrolysis of V-series nerve agents. Exposure Hazards... 

Symptoms Nerve agents exposures results in rhinorrhea, chest tightness, pinpoint pupils, shortness of breath, excessive salivation and sweating, nausea, vomiting, abdominal cramps, involuntary defecation and urination, muscle twitching, confusion, seizures, flaccid paralysis, coma, respiratory failure, and death. 

Pyridostigmine About twelve years ago, the U. S. military provided pyridostigmone bromide as a pretreatment for nerve agent exposure. Each trooper received a blister pack... 

Pyridostigmine About twelve years ago, the U.S. military provided pyridostigmone bromide as a pretreatment for nerve agent exposure. Each trooper received a blister pack containing twenty-one 30-mg tablets for a dose regimen of one 30-mg tablet every eight hours. When given before soman exposure and when that exposure is followed by the standard MARK I therapy, the use of this pretreatment will increase the LD-50 several fold over the LD-50 obtained without the use of the pretreatment. When soman is the nerve... 

Pyridostigmine Bromide An antidote enhancer that blocks acetylcholinesterase, protecting it from nerve agents. When taken in advance of nerve agent exposure, pyridostigmine bromide increases survival provided that atropine and oxime and other measures are taken. 

In June 1994 and again in May 1995 the Japanese cult group Aum Shinrikyo created much havoc when they released the deadly nerve agent sarin in two Japanese cities. In the first attack in Matsumoto, Japan, sarin vapor was released in a residential area where judges unfriendly to the cult resided. Seven people died as a consequence of this nerve agent exposure, and 500 people were injured. The 1995 attack occurred in the Tokyo subway system. Several coordinated releases of this potentially deadly vapor resulted in more than 5,000 visits to local emergency departments. Fortunately, the vast majority of exposed victims had few if any symptoms and there were only a handful of fatalities (Tucker, 2006 for further discussion, see chapter 19—Biological and Chemical Terrorism A Unique Threat). 

Pfaff, B. L. (1998). Emergency department management of nerve agent exposure. International Journal of Trauma Nursing, 4(3), 71-78. 

Characterizing biological variability in livestock blood cholinesterase activity for biomonitoring organophosphate nerve agent exposure. J. Am. Vet. Med. Assoc. 201 714-725. 

Halbrook, R.S., L.R. Shugart, A.P. Watson, N.B. Munro and R.D. Linnabary. 1992. Characterizing biological variability in livestock blood cholinesterase activity for biomonitoring organophosphate nerve agent exposure. J. Amer. Vet. Med. Assoc. 201 714-725. 

Anticholinesterase effects of nerve agent exposure can be characterized as muscarinic, nicotinic, or CNS. Muscarinic effects occur in the parasympathetic system and, depending on the amount absorbed, can be expressed as conjunctival congestion, miosis, ciliary spasm, nasal discharge, increased bronchial secretion, bronchoconstriction, anorexia, emesis, abdominal cramps, sweating, diarrhea, salivation, bradycardia, and hypotension. Nicotinic effects are those that... 

A good deal of nerve agent toxicity research performed and published since the mid-1990s has served to bring a more widespread awareness of the knowledge that detectable (either by means of devices or manifestation of signs) low-level nerve agent exposures under a variety of scenarios are... 

TABLE 6.7. Recommended antidote protocol for emergency nerve agent exposure therapy ... 

Cannard, K. (2006). The acute treatment of nerve agent exposure. J. Neurol. Sci. 249 86-94. 

Dunn, M.A., Hackley, B.E., Sidell. F.R. (1997). Pretreatment for nerve agent exposure. In Medical Aspects of Chemical and Biological Warfare (F.R. Sidell, E.T. Takafuji, D.R. Franz, eds), pp. 181-96. Office of the Surgeon General, Walter Reed Army Medical Center, Washington, DC. 

Leikin, J.B., Thoman, R.G., Walter, F.G., Klein, R., Meislin, H.W. (2002). A review of nerve agent exposure for the critical care physician. Crit. Care Med. 30 2346-54. 

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