Nerve agents pulmonary effects

These pesticides inhibit acetylcholine esterase and produce effects similar to, but much milder and more transient than, nerve agents. In some cases, inhalation exposure may also lead to pulmonary edema. 

Impairment of breathing is an early effect of exposure to nerve agent vapor or aerosol. When the exposure is small, the casualty may have mild to severe dyspnea, with corresponding physical findings, and the impairment will be reversed by the administration of atropine. If the distress is severe and the casualty is elderly or has pulmonary or cardiac disease, the antidote may be supplemented by providing oxygen by inhalation. In most other circumstances, supplementation with oxygen is unnecessary. 

Casualties who improve significantly from one or two MARK I kits given for nerve agent symptoms will continue their mission on improvement. Those casualties who later develop symptoms after vesicant or pulmonary agent exposure will seek medical aid either at the unit aid station or at the BAS. Generally, they will decide to seek assistance before the effects become severe, and they will trans-... 

The aminopyridines (4-aminopyridine 3,4-diaminopyri-dine) accelerate spontaneous exocytosis at central and peripheral synapses. There is also an increase in the number of transmitter quanta released by a nerve action potential. This is probably the result of increased Ca++ inflow at the terminals due to a reduction of K+ conductance and prolongation of the nerve action potential. Muscle strength is increased in patients with the Lambert-Eaton myasthenic syndrome and in others poisoned with botuUnum E toxin (discussed later). Improvement in uncontrolled spasms, muscle tone, and pulmonary function is noted in patients with multiple sclerosis or long-standing spinal cord damage. Side effects that limit clinical utility include convulsions, restlessness, insomnia, and elevated blood pressure. Of the two agents, 3,4-diaminopyridine is the more potent and crosses the blood-brain barrier less readily. 

Primary pulmonary hypertension and cardiac valve disorders have been associated with other centrally acting weight loss agents that cause release of serotonin from nerve terminals although sibutramine has not been associated with these effects in premarketing clinical studies, patients should be informed of the potential for these side effects and monitored closely for their occurrence... 

Despite being a wonder drug against malaria, quinine in therapeutic doses can cause various side-effects, e.g. nausea, vomiting and cinchonism, and in some patients pulmonary oedema. It may also cause paralysis if accidentally injected into a nerve. An overdose of quinine may have fatal consequences. Non-medicinal uses of quinine include its uses as a flavouring agent in tonic water and bitter lemon. 

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