Pulmonary agents phosgene

The pulmonary agent phosgene was used extensively as a chemical weapon in WW I. Nowadays, it is an important intermediate for industrial production of insecticides, isocyanates, plastics, aniline dyes and resins, with an estimated yearly production of almost 1 billion pounds. Reliable diagnosis of exposure to phosgene, other than observation of the developing edema by means of chest roentgenology, is not available. 

Pulmonary agents phosgene, chlorine, vinyl chloride... 

Pulmonary agents (phosgene, phosphine, chlorine, anhydrous ammonia, etc.) cause immediate irritation of eyes and throat and then coughing, tightness in chest, and difficulty breathing. 

Pulmonary/ choking agents phosgene, chlorine, diphosgene, chloropicrin, oxides of nitrogen, and sulfur dioxide. 

Blood/pulmonary agents, which interfere with metabolic functions such as hydrogen cyanide (AC) or phosgene (CG). 

After completing decontamination, the only effective management consists of close observation for the development of respiratory distress and supportive care. There are no known antidotes for pulmonary agent exposure. Patients exposed to phosgene or diphosgene require monitoring for a minimum of 12h because of the possibility of delayed symptoms (2). Strict bed rest is essential for patients with mild and moderate exposmes, because any exertion, even minimal exertion, can shorten the clinical latent period and inaease the severity of respiratory symptoms (8). In symptomatic patients, physical activity can cause clinical deterioration and even death (8). Supportive care consists of managing secretions, bronchospasm, hypoxia, and pulmonary edema. 

Animal studies and human case reports have led to several proposed postexposure prophylactic regimens for asymptomatic patients exposed to pulmonary agents, specifically phosgene, to prevent development of complications. Unfortunately, all of these treatments lack evidence in systemic studies, and asymptomatic patients may find at least one of the treatments unacceptable ... 

Choking/Lung/Pulmonary Agents 157 Phosgene (CG) 157 Chlorine (CL) 158 Phosphine 160 White Phosphorus 161... 

Phosgene was used as a major CW agent in WW I and was responsible for the greatest number of CW induced mortalities. It causes a lethal pulmonary oedema after an asymptomatic lag phase of up to 24 h. Its specific mechanism of action is unknown, but is assumed to involve reactions with nucleophilic sites on macromolecules. 

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