Sarin drugs

Dolgin, E., 2013. Syrian gas attack reinforces need for better anti-sarin drugs. Nat Med. 19, 1194-1195. 

Little PJ, Scimeca JA, Martin BR. 1988. Distribution of (3H)diisopropyl flourophosphate, (3H)soman, (3H)sarin, and their metabolites in mouse brain. Drug Metab Dispos 16(4) 515-520. 

Dr. Aghajanian also tried the nerve agent GB (sarin) as a possible antidote. It worked quite well, as did VX, another well-known lethal nerve agent. He and Dr. Sidell sueeessfully used both drugs to reverse EA 3580 intoxieation. If not for the general publie fear of anything to do with nerve gas, one might reeommend sarin or VX as superior antidotes to use in the treatment of dmg-indueed delirium. 

The specter of chemical death persists. Like atom bombs, chemical weapons have been classified as weapons of mass destruction. But were they, and are they Nerve agents such as VX and sarin can certainly kill swiftly. But so can hundreds of familiar drugs and poisons. The real question is whether anyone within the limits of current technology can, in fact, use them effectively as lethal weapons on the battlefield. 

Thus, treatment without the use of an oxime agent is possible. Of course, ideally, in countries where this is economically possible, treatment should use the three recommended drugs (I) atropine, (2) an oxime agent like PAM, and (3) diazepam, and the use of autoinjectors for administration is also helpfiil. Unfortunately, terrorist attacks using sarin are also carried out in less economically developed countries and even if the drugs are available, considerations related to cost performance need to be considered. In this sense, preference should be given to the availability of atropine and diazepam. In other words, unless it is economically feasible, funds should be used to obtain atropine and diazepam, rather than oxime agents, whose cost-benefit ratio is still inconclusive. 

Bajgar, J., Bartosova, L., Kuca, K., Jim, D., Fusek, J. (2007). Changes in cholinesterase activities in the rat blood and brain after sarin intoxication preheated with butyrylcholinesterase. Drug Chem. Toxicol. 30 351-9. 

Adams, T.K., Capacio, B.R., Smith, J.R., Whalley, C.E., Korte, W.D. (2004). The application of the fluoride reactivation process to the detection of sarin and soman nerve agent exposure in biological samples. Drug Chem. Toxicol. 27 77-91. 

Clinical experience with the use of PAM-2 iodide, given with atropine and diazepam, in the treatment of the victims of the Tokyo sarin attack in 1995 was extremely favourable (Stojdjkovic and Jokanovic, 2005). Still, 2-PAM should not be recommended as the drug of choice due to its lack of efficacy against tabun and soman (Kassa, 2005). 

Sarin, Y.K. (1996). Illustrated manual of herbal drugs used in Ayurveda National Institute of Science Communication (CSIR). Dr. K.S. Krishnan Marg. New Delhi, India. 

Harris, L.W. et al. Physostigmine (alone and together with adjunct) pretreatment against soman, sarin, tabun and VX intoxication. Drug Chem. Toxicol, 14, 265, 1991. 

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