Sarin atropine therapy

Treatment of the victims exposed to sarin and VX in the Japanese terrorist incidents is similar in many ways to the descriptions of the Sidell casualties . All victims were seen in hospital emergency rooms where treatment was initiated. In cases of severe poisoning, atropine therapy was given IV, which insures maximum therapeutic effect within minutes. Nozaki and Aikawa (1995) described the treatment of one severely poisoned patient of the Tokyo subway exposures at Keio University Hospital. The patient arrived at the hospital in a coma 1 h after exposure (Glasgow coma scale El M1V1), displaying profuse sweating and oral secretions, convulsions,... 

FIGURE 10.1 Effectiveness of galantamine/atropine as an antidote against the acute toxicity and lethality of 1.5 X LD50 soman or sarin in guinea pigs. Note that there is no need for additional supportive therapy. (From Albuquerque, E.X. et al., Proc. Natl. Acad. Sci. USA, 103, 13220, 2006. With permission.)... 

Nerve agents have caused polyneuropathy in animals only at doses manyfold greater than the LD50 (the dose [D] that is lethal [L] to 50% of the exposed population)—doses that require massive pretreatment and therapy to ensure survival of the animals. Davies et al33 produced polyneuropathy in chickens with sarin only at 60 or more times the LD5q. (The animals were protected with atropine and oxime to permit survival.) Neuropathy was not detected at 8 times the medial lethal dose of soman. Davies s group also detected no polyneuropathy at doses of VX of 45 pmol/kg.34... 

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