Vesicants nitrogen mustards

Mechlorethamine [me klor ETH a meen] was developed as a vesicant (nitrogen mustard) during World War I. Its ability to cause lymphocytopenia led to its use in lymphatic cancers. Because it can bind and react at two separate sites, it is called a bifunctional agent. ... 

Sulfur mustard reacts rapidly with chlorine or with bleach, and this reaction is a suitable means of decontamination. Nitrogen mustards, however, chlorinate extremely slowly thus chlorination is not suitable for their decontamination. The formation of water-soluble salts, such as by neutralization with sodium bisulfate, is the usual method for nitrogen mustard removal from contaminated surfaces. The mustard salts are much less vesicant than the corresponding free bases. 

Vesicants/blister agents sulfur mustard, lewisite, nitrogen mustard, mustard lewisite, and phosgene oxime. 

Nitrogen mustard—potent vesicant—avoid extravasation decomposes rapidly after mixing must not be mixed in same syringe with any other drug... 

The group Cl CH2 CH2 N< occurs in the nitrogen mustards which are powerful vesicants, e.g. CH3,N(CH2,CH2C1)2. It was decided therefore to introduce this group into the fluoroacetamide molecule in the hope of combining vesicant properties with the delayed convulsant action of the fluoroacetates. For this purpose N-2 hydroxyethylfluoroacetamide (IV) was prepared by the action of monoethanolamine on methyl fluoroacetate and was readily converted into N-2-chloroethylfluoroacetamide (V) by the action of thionyl chloride ... 

Toxicology. Nitrogen mustards are vesicants and alkylating agents that damage the respiratory airways and cause skin and eye burns. 

Nitrogen mustards are tertiary hw(2-chloroethyl)amines with vesicant activity (NDRC, 1946). AH are active alkylating agents. The nomenclature, chemical and physical properties of HNl, HN2, and HN3 are summarized in Tables 8.3 and 8.4. Due to their toxicity and various... 

CWAs have been widely eondemned since they were first used on a massive scale during World War I. However, they are still stockpiled and used in many countries as they are cheap and relatively easy to produee, and can cause mass casualties. Although the blood agent CK is extremely volatile and undergoes rapid hydrolysis, the degradation of three types of vesicant CWAs, the sulfur mustards, nitrogen mustards, and Lewisite, results in persistent products. For... 

The bulk of what is known about human skin injury from SM has been gathered from victims of the mihtary use of the compoimd (Balali-Mood and Hefazi, 2006 Hefazi et al., 2006 Requena et al, 1988). Nevertheless, there are several reports where the cutaneous vesicating effects of SM were studied experimentally in human subjects (Papirmeister et al, 1991a, b Dacre and Goldman, 1996). In one comparative study (Daily et al, 1994) 12 volunteers had forearm vapor cup applications of SM, trifunctional nitrogen mustard (HNS), and lewisite. The conclusions were... 

Wormser, U., Brodsky, B., Green, B.S., Arad-Yellin, R., Nyska, A. (1997). Protective effect of povidone-iodine ointment against skin lesions induced by sulphur and nitrogen mustards and by non-mustard vesicants, Toxicol. 71 165-70. 

Toxic effects of sulfur mustard and ethyleneimine on animals were described in the 19th century. The powerful vesicant action of sulfur mustard led to its u.se in World War I. and medical examination of the victims revealed that tissues were damaged at sites distant from the area of contact." Such systemic elTects included leukopenia, bone marrow aplasia, lymphoid tissue suppression, and ulceration of the gastrointestinal tract. Sulfur mustard was shown to be active against animal tumors, but it was too nonspecific for clinical use. A variety of nitrogen mustards were synthesized between the two world wars. Some of these compounds (e.g.. 

See also Bio Warfare and Terrorism Toxins and Other Mid-spectrum Agents Biister Agents/Vesicants Chemi-cai Warfare Deiivery Systems Nen/e Agents Nitrogen Mustard. 

After sulfur and nitrogen mustards are absorbed and interact with body tissues, they are no longer intact molecules. Therefore, unlike nerve gas victims, the body fluids of decontaminated mustard-exposed patients pose no risk to health care providers or other responders (2). In contrast to the other vesicants, Lewisite does not require a cyclization reaction, so its effects are immediate. Through direct inhibition of thiol-containing enzymes. Lewisite disrupts energy pathways, causing ATP depletion, cell death, and clinical effects (15). 

Sulfur and Nitrogen Mustard Vesicant Exposure Clinical Presentation and Diagnosis... 

All vesicant-exposed patients should have a CBC performed daily. Treatment of bone marrow suppression should include infection precantions, transfusions, and aggressive treatment of infections as indicated (3). Smdies indicate that granulocyte colony-stimulating factor (GCSF) may be usefnl for bone marrow suppression secondary to nitrogen mustard exposure (25,26). Bone marrow transplantation may be useful, but evidence is limited. Any mustard-exposed patient with a marked decrease in white blood cell count requires reverse isolation in an oncology or bnm unit (25,26). 

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