Term
| tabun (GA), sarin (GB), soman (GD), VX |
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Definition
organophosphorous compounds;
liquid at room temp., fairly volatile;
Route of Exposure - inhalation, skin, eye;
MoA:
- potent inhibitors of AChesterase;
S/Sx of Poisoning:
- eye: severe miosis, lacrimation, blurring of vision;
- lung: severe bronchoconstriction, increased secretion;
- GI tract: severe increase in motility, secretion, N/V, diarrhea, cramping;
- bladder: urinary incontinence;
- sweat glands: diaphoresis;
- cardiovascular: brady/tachycardia, hypo/hypertension, shock;
- neuromuscular junction: twitching, fasciculations, paralysis;
- CNS: loss of consciousness, seizures, apnea; |
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Term
| atropine + pralidoxime (2-PAM) |
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Definition
muscarinic antagonist administered to someone with AChesterase inhibitor first, then add next drug to reactivate the enzyme;
Use as soon as possible following exposure; |
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Term
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Definition
| used for controlling seizures |
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Term
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Definition
reversible carbamate inhibitor of AChesterase; widely used in tx of myasthenia gravis; used as a protective agent against nerve agents;
Give PRIOR to expoposure to nerve agent, protects from subsequent exposure to organophosphate nerve agent;
"Pre-exposure antidotal enhancement";
NOT EFFECTIVE if given after exposure to nerve agent; |
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Term
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Definition
Exposure - inhalation or oral;
MoA:
- binds to cytochrome oxidase which inhibits electron transport chain & interferes with cell's ability to utilize O2; cells throughout body can be affected, respiratory centers in brain are especially susceptible; respiratory failure is usual cause of death;
S/Sx of Poisoning:
- Inhalation: rapid onset, initial tachypnea, loss of consciousness, seizures, apnea, cardiac arrest, death may occur in 5 min;
- Oral/Cutaneous: slower onset, early stage (weakness, vertigo, nausea, HA), later stages (mental disturbances, confusion, ataxia, seizures, coma, death), death may occur after 30 min with high doses, several days with lower doses; |
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Term
| inhaled amylnitrite OR IV sodium nitrite |
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Definition
| first step in treatment of cyanide poisoning, interacts with hemoglobin to form methemoglobin |
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Term
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Definition
second step in treatment of cyanide poisoning;
- catalyzes conversion of cyanide to thiocyanate which is harmless and can be excreted by kidney |
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Term
| hydroxycobalamin (Cyanokit) |
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Definition
new antidote for cyanide poisoning;
- precursor of cyanocobalamin (vitamin B12), given IV, binds to cyanide & forms cyancobalamin;
Main Side Effects:
- red color of skin, urine, transient hypotension, HA, nausea, allergic reactions; |
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Term
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Definition
Exposure: cutaneous or mucous membranes of nasal passages, respiratory tree, & eyes;
MoA & Effects:
- initially non-irritating but is chemically very reactive; after 1-2 min it binds covalently to molecules in skin and causes delayed responses (erythema, blistering) that occurs after 2-48 hrs;
Effects: mild erythema to severe, life threatening blisters depending on level & duration of exposure; death results from injury to upper airway and lung, or subsequent infections of cutaneous burns & blisters; Ocular exposure - permanent visual impairment, blindness; |
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Term
| Treatment for Sulfur Mustard |
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Definition
very difficult to treat;
water & soap can decontaminate but must do this in 1-2 mins;
Tx is mainly symptomatic;
Use O2, bronchodilators, assisted ventilation for pulmonary effects;
Bone marrow suppression may require blood transfusion or marrow transplants; |
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Term
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Definition
a vessicant agent whose main effects resemble those of sulfur mustard but has a lower freezing point;
More rapid onset of action, pain within minutes, blistering within 1-2 hours, and causes pronounced capillary leakage and pulmonary edema; |
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Term
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Definition
| effective antidote for Lewisite poisoning |
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Term
| chlorine, phosgene (pulmonary agents) |
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Definition
gases denser than air, widely used in industry, readily available;
Exposure by inhalation;
MoA:
- both generate HCl causing tissue necrosis, interacts with S-H groups and induces oxidative stress;
Effects:
- necrosis of nasal mucosa & upper airway, disruption of alveolar septum results in pulmonary edema & hemorrhage, microbial superinfection, initial symptoms (ocular irritation, nasal irritation, choking, coughing, laryngospasm, suffocation), pulmonary edema appears in 2-4 hrs;
Tx:
- ventilation;
- monitor for S/Sx of infection & administer antibiotics as needed; |
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Term
| atropine, scopolamine, benzactyzine |
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Definition
| anticholinergic agents that produce disturbances of consciousness and mental function; |
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Term
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Definition
| hallucinogen used to produce disturbances of consciousness & mental function; |
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Term
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Definition
| opioid used to produce disturbances of consciousness and mental function |
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Term
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Definition
extremely toxic protein derived from beans of castor plant;
Exposure: injection, ingestion, or inhalation;
MoA: inhibits protein synthesis;
Symptoms: depends on route of exposure - pulmonary edema, GI distress, bleeding, shock resulting in death after 2-3 days;
No specific antidote, only symptomatic treatment; |
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