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Review of oximes available for treatment of nerve agent poisoning
Author(s) -
Dawson R. M.
Publication year - 1994
Publication title -
journal of applied toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.784
H-Index - 87
eISSN - 1099-1263
pISSN - 0260-437X
DOI - 10.1002/jat.2550140502
Subject(s) - nerve agent , oxime , soman , tabun , sarin , pyridostigmine , atropine , pharmacology , diazepam , pralidoxime , chemistry , medicine , acetylcholinesterase , anesthesia , organic chemistry , myasthenia gravis , enzyme
A review was conducted of papers describing the use of N ‐methyl‐2‐pyridinealdoxime (PAM), toxogonin or HI‐6 as antidotes to the nerve agents tabun, sarin, soman and VX. The review included use of the oxime alone, oxime plus atropine and oxime plus atropine plus diazepam, given therapeutically, i.e. after nerve agent, in all cases. Experiments with any of these compounds given prophylactically were not considered. The review also included protocols of pyridostigmine prophylaxis and oxime‐atropine therapy (with or without diazepam). It was difficult to draw conclusions as to the best oxime to use, because of lack of data in many cases. The identity of the oxime did not appear to be important when pyridostigmine prophylaxis was combined with atropine‐oxime‐diazepam therapy; in these cases, very good protection was observed in guinea pigs against all four nerve agents. The choice of oxime based on the data presently available may well depend on factors other than protection against lethality, such as cost and availability of the oxime and human toxicity of the oxime. This last factor was also reviewed, and the results showed that toxogonin is likely to cause more side‐effects than PAM or HI‐6. The efficacy of the oximes against the emerging threat agent GF was also reviewed.