Prophylaxis with oximes

Crook, J. W Goodman. A. L, Colbourn, J. 1... Zvirblis, R, Oberst, F W., and Wills. J. H. (1962). Adjunctive value of oral prophylaxis with the oxime.s 2-PAM lactate and 2-PAM meihancsuifnnatc to therapeutic administration of atropine iti dogs poisoned by inhaled sarin vapor. J. Pharmacol. Exp. TherA3fr, 397-399. 

The animal should be bathed with copious amounts of water and a mild soap. Phosgene oxime reacts quickly with tissue and decontamination is not expected to be entirely effective after pain has been produced. Sodium hypochlorite (0.5%) or isotonic sodium bicarbonate can help neutralize phosgene oxime that has not yet reacted with tissue. Bums should be managed with topical silver sulfadiazine and systemic antibiotics as needed (Roberts, 1988). Horses and sheep should receive tetanus prophylaxis. Other species should be vaccinated on a case by case basis. 

Medical response, treatment and prevention (prophylaxis) to nerve agent exposure are ever expanding fields of research [6,12,13]. Atropine, which rapidly reverses cholinergic over expression at synapse junctions, is the most commonly used anticholinergic. Mark I kits, which contain 2 mg atropine with an autoinjector for intramuscular use, are issued to US military personnel [2]. Recommended initial field doses for atropine are 2, 4 or 6 mg with re-treatment every 5-10 min depending on the symptoms. In addition, oximes reactivate cholinesterase enzymes, ensuring normal function. Mark I kits also include 600 mg autoinjectors of 2-pralidoxime chloride (2-PAM Cl) with initial field doses of 600, 1200 or... 

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