Disease Information for Nerve gas exposure: Definition

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  • Nerve agents used in chemical warfare work by cholinesterase inhibition and are most commonly organophosphorus compounds; Agents such as tabun (dimethylphosphoramidocyanidic acid ethyl ether) and sarin (methylphosphonofluoridic acid 1-methylethyl ester) are similar to insecticides such as malathion but are vastly more potent; They may be inhaled or absorbed through the skin; Systemic effects due to unopposed action of acetylcholine include miosis, salivation, abdominal cramps, diarrhea, and muscle paralysis producing respiratory arrest; Inhalation also produces severe bronchoconstriction and copious nasal and tracheobronchial secretions; Treatment: Perform thorough decontamination of exposed areas with repeated soap and shampoo washing; Personnel caring for such patients must wear protective clothing and gloves, since cutaneous absorption may occur through normal skin; Specific Treatment; Give atropine in an initial dose of 2 mg intravenously, and repeat as needed to reverse signs of acetylcholine excess; (Some victims have required several hundred milligrams) Treat also with the cholinesterase-reactivating agent pralidoxime, 1–2 g intravenously initially followed by an infusion at a rate of 200–400 mg/h; United States military personnel in the Persian Gulf war were equipped with autoinjectable units containing 2 mg of atropine plus 600 mg of the cholinesterase-reactivating agent pralidoxime-------(Current Medical DX RX 2005)--------------

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