Prophylaxis against Organophosphorous Nerve Agents - State of the Art (profylaxe tegen organofosfaat zenuwgassen - stand van zaken)
Abstract
Prophylaxis against chemical warfare agents may reduce the extent of the intoxication and thereby improve the prognosis for the patient. Since treatment for intoxications with organophosphorous (OP) acetyicholinesterase (AChE) inhibitors is still far from ideal, research efforts are devoted towards finding an effective prophylaxis. A successful prophylaxis should fulfill 3 conditions: 1) offering a high protection rate, 2) causing no side effects, and 3) protecting against post-intoxication incapacitation. The mechanism of action of the currently available prophylaxis pyridostigmine is to protect a fraction of the enzyme from binding with irreversible OP AChE inhibitors. However, because if its structure, pyridostigmine hardly penetrates the brain and will therefore not protect the brain AChE sufficiently. This may lead to brain damage and post-intoxication incapacitation. Therefore, alternatives for pyridostigmine should be evaluated. For the near future, prophylaxis with physostigmine and scopolamine seems to be the best choice and most promising alternative to prevent OP intoxication. For the intermediary term, research towards compounds with another mechanism of action, like procyclidine, should be considered. For the long term the use of scavengers can be evaluated. This report is a new reviewed version of the former report PML 2002-A94 "Profylaxis against Organophosphorous nerve agents-state of the art".
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2005
- Accession Number
- ADA449857
Entities
People
- I. H. Philippens
Organizations
- Prins Maurits Laboratorium TNO