ACETYLCHOLINESTERASE INHIBITORS TOXICITY

Course overview

NERVE AGENTS ARE SOME OF THE MOST DEADLY AND EASILY EMPLOYED CHEMICAL WARFARE AGENTS. GIVEN THE GLOBAL THREAT OF TERRORISM, IT IS PRUDENT TO HAVE A BASELINE KNOWLEDGE OF NERVE AGENTS. SOME OF THE MORE RECOGNIZABLE NERVE AGENTS ARE SARIN [(RS)-PROPAN-2-YL METHYPHOSPHONOFLUORIDATE], ALSO KNOWN AS GB; SOMAN (O-PINACOLYL METHYLPHOSPHONOFLUORIDATE), ALSO KNOWN AS GD; AND VX (ETHYL ({2-[BIS(PROPAN-2YL)AMINO]ETHYL}SULFANYL)(METHYL)PHOSPHINATE). INITIALLY DEVELOPED IN THE EARLY-TO-MID 1900S FROM CHEMICALLY SIMILAR INSECTICIDES, THEIR VOLATILITY AND POTENTIAL TO BE WEAPONIZED WAS EXPLOITED DURING WORLD WAR II. MORE RECENT EXAMPLES OF NERVE AGENT USE INCLUDE THE 1995 TOKYO SUBWAY ATTACK WITH SARIN GAS AND THE 2017 ASSASSINATION OF KIM JONG-NAM WITH VX GAS. THIS ACTIVITY REVIEWS SOME OF THE MORE COMMON NERVE AGENTS USED, THEIR ASSOCIATED SIGNS AND SYMPTOMS, AND RECOMMENDATIONS FOR MANAGEMENT. THIS ACTIVITY REVIEWS THE IMPORTANCE OF THE INTERPROFESSIONAL TEAM IN DIAGNOSING AND TREATING PATIENTS EXPOSED TO NERVE AGENTS.