Soman antidotes

Another disadvantage of the first generation reactivators lies in their lacking of antidotic effect in respect to affections induced by soman, which causes fast aging of the phosphorylated enzyme. 

HI-6 is the most efficacious antidote in poisonings with soman. This agent has less toxicity as compared with HS, H6-6, toxogonine and 2-PAM. 

Nerve Agent Antidote Kit (NAAK or MARK I) consists of an atropine auto-injector (2 mg), a pralidoxime chloride auto-injector (2-Pam-Cl, 600 mg), the plastic clip joining the two injectors, and a foam case. The kit serve as a countermeasure to nerve agents, including tabun (GA), sarin (GB), soman (GD), GF, and VX. Military personnel can receive three MARK I for self/buddy aid. Possible side effects of atropine and/or 2-PAM-C1 are deemed insignificant in a nerve agent casualty. Intravenous atropine and 2-PAM-C1 can also be made available. The MARK I kit is manufactured by Survival Technology, Inc., Rockville, Maryland. 

Loomis, T.A., Salafsky, B. 1963. Antidotal action of pyrldl-nium oximes in anticholinesterase poisoning comparative effects of soman, sarin, and neostigmine on neuromuscular function. 

Lallement, G., Masqueliez, C., Baubichon, D. et al. (2004). Protection against soman-induced lethality of the antidote combination atropine-pralidoxime pro-diazepam packed as freeze-dried form. J. Med. Chem. 2 1-11. 

The presence of sarin, soman, and VX in the brain demonstrates the necessity for antidotes, especially AChE reactivators, to be capable of passing the blood-brain barrier, representing a current scientific challenge (Lorke et al, 2008 Okuno et al, 2008). 

Kassa, J. (2006). Therapeutic and neuroprotective efficacy of pharmacological pretreatment and antidotal treatment of acute tahun or soman poisoning with the emphasis on pretreatment drug PANPAL. Arh. Hig. Rada Toksikol. 57 427-34. 

Kassa, J., Fusek, J. (1998). The positive influence of a cholinergic-anticholinergic pretreatment and antidotal treatment on rats poisoned with supralethal doses of soman. Toxicology 128 1-7. 

Kassa, J., Fusek, J. (2000). The influence of anticholinergic drug selection on the efficacy of antidotal treatment of soman poisoned rats. Toxicology 154 ... 

Koupilova, M., Kassa, J. (1999). The influence of Panpal pretreatment on the elimination of soman-induced neurotoxicity by antidotes in rats. Homeostasis 39 133-5. 

The only two randomized controlled clinical trials performed so far did not result in a final proof of the efficacy of the oximes in the treatment of poisonings induced by the OP insecticides in humans due to methodological problems (Eddleston et al., 2002). However, experimental and clinical experience suggests that among the pyridinium oximes, obidoxime andtrimedoxime, although relatively toxic, could provide reactivation and antidotal protection against most of the OP insecticides. In addition, HI-6 has proved to be effective in the treatment of soman-poisoned animals and safe and effective in patients poisoned with diethoxy OPs. 

Oldiges, H., Schoene, K. (1970). Pyridinium und imidazolinium-salze als antidote gegeniiber soman- und paraoxon vergiftun-gen bei mause. Arch. Toxicol. 26 293-305. 

Pazdemik, T.L., Nelson, S.R., Cross, R., Churchill, L., Giesler, M., Samson, F.E. (1986). Effects of antidotes on soman-induced brain damage. Arch. Toxicol. 9 333-6. 

All the synthesized compounds were tested both in vivo on mice intoxieated by soman or tabun and in vitro on human erythrocyte AChE. In conclusion, nitro, sulfone, amino, and aminosulfonyl side-chain substituents caused high antidotal activity, where the optimum length of side-... 

Maxwell, D. M., Brecht, K. M., Doctor, B. P., Wolfe, A. D. (1993). Comparison of antidote protection against soman by pyridostigmine, HI-6 and acetylcholinesterase. Journal of Pharmacology and Experimental Therapeutics, 264, 1085—1089. 

Oldiges, H. and Schoene, K. Pyridinium and imidazolium salts as antidotes for soman and paraoxon poisoning in mice, Archiv fur Toxikologie, 26, 293, 1970. 

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.)... 

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