Therapeutics post-exposure

The therapeutic efficacy of diverse mono and bis-quaternary pyridine aldoximes as antidotes against OP poisoning has been established in hundreds of publications, and three of them, 2-PAM (38), toxogonin (40) and HI-6 (41), are available in autoinjectors for post-exposure self-treatment or treatment by medical staff. For further information on the clinical use and potential side effects of these oximes the reader is referred to the reviews of Kassa, Eyer and of Marrs and colleagues . ... 

Lethality was prevented by treatment with nasal atropine (atropine methyl nitrate) and post-exposure treatment with atropine methyl bromide instillation in combination with pulmonary therapeutic surfactants or liquevents in guinea pigs exposed to approximate LC50 concentrations of VX aerosol (Nambiar et ah, 2007) this concept shows promise for operational application in emergency response. 

Several therapeutics are approved for post-exposure treatment. For anthrax, current military doctrine calls for initiating treatment with oral ciprofloxacin or doxycycline as soon as exposure to spores is suspected, and introducing intravenous ciprofloxacin at the earliest signs of infection or disease. The vaccination series should also be administered to victims not immunized in the previous 6 months. Antibiotic treatment should be continued for at least 4 weeks, during which time the victim should also receive a series of vaccinations. 

The therapeutic efficacy of oral administration of seed powder of M. oleifera (500 mg/kg, orally, once daily) post arsenic exposure (100 ppm in drinking water for 4 months) in rats has been investigated (49). Animals exposed to arsenic(lll) shows a significant inhibition of 8-aminolevulinic acid dehydratase (ALAD) activity, decrease in reduced glutathione (GSH) level and an increase in reactive oxygen species (ROS) in blood. On the other hand, a significant decrease in hepatic ALAD, and an increase in 8-aminolevulinic acid synthetase (ALAS) activity is observed after arsenic exposure. These changes... 

Combinatorial Y and TACE presents an interesting opportunity to assess the cumulative effect of these modalities in effecting tumor kill. Intraarterial infusion of Y in an aerobic environment (non-stasis) could be followed by TACE after the radioactive effect diminishes to sub-therapeutic levels (approximately 2 weeks post Y treatment). TACE administration with cytotoxic tumor exposure in a hypoxic environment would then address any viable (radioresistant) cells that remained. 

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