Organophosphorus nerve agent treatment

Shih, T.M., McDonough, J.H., Jr. (1999). Organophosphorus nerve agents-induced seizures and efficacy of atropine sulfate as anticonvulsant treatment. Pharmacol. Biochem. Behav. 64 147-53. 

Kassa, J. (2002). Review of oximes in the antidotal treatment of poisoning by organophosphorus nerve agents. J. Toxicol. Clin. Toxicol. 40 803-16. 

Marrs, T.C. and Sellstroulm, A., 2007. The use of benzodiazepines in organophosphorus nerve agent intoxication, in Chemical Warfare Agents Toxicology and Treatment, 2nd ed., Marrs, T.C., Maynard, R.L., and Sidell, E, Eds., John Wiley Sons, West Sussex, England, chap. 16. 

Important measures in prevention of military casualties include adequate detection measures, physical protection, chemical prophylaxis and proper treatment. In the terrorist context, proper emergency planning is key. Treatment of poisoning by organophosphorus nerve agents is dealt with in other chapters in this volume. 

Shih T-M and McDonough JH (2000). Efficacy of biperiden and atropine as anticonvulsant treatment for organophosphorus nerve agent intoxication. Arch Toxicol, 74, 165-172. 

Amino-3-methylpyridine (29) has been used for synthesis fluorine-containing pyridine aldoximes of potential use for the treatment of organophosphorus nerve-agent poisoning [30]. The Baltz-Schiemann technique was used to convert 2-amino-3-methylpyridine into 2-flnoro-3-methylpyridine (30), subsequent permanganate oxidation of 30 provided acid 31. Finally conversion of 31 to acyl chloride 32 and Rosenmund reduction resnlted in carboxaldehyde 33. Previously this technique was reported to give poor yields with heterocyclic acyl chlorides. The conversion of 32... 

Exposure to nerve agents is not restricted to the battlefield. Possible terrorist use of these weapons and the destruction of the chemical weapon depots certainly will increase the risk of exposure. Since treatment for intoxication with at least some of these organophosphorus (OP) acetylcholinesterase (AChE) inhibitors is still far from ideal, research efforts are devoted towards finding an effective treatment. 

Sogorb M.A., Vilanova, E., Carrera, V. (2004). Future applications of phosphotriesterases in the prophylaxis and treatment of organophosphorus insecticide and nerve agent poisonings. Toxicol. Lett. 151 219-33. 

Thiermann, H., Szinicz, L., Eyer, P., Felgenhauer, N., Zilker, T., Worek, F. (2007). Lessons to be learnt from organophosphorus pesticide poisoning for the treatment of nerve agent poisoning. Toxicology 233 145-54. 

Department of Health, UK (2005). Pre-hospital guidelines for the emergency treatment of deliberate release of organophosphorus (OP) nerve agents. London, UK Department of Health (www.dh. uk/policyAndGuidance/EmergencyPlanning/ DeliberateReleaseChemical). 

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