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The ATNAA provides atropine and pralidoxime chloride in a single delivery system, although the two drugs are separate within the device. [1] [2] The use of the device is only to be administered in the extreme case of organophosphate poisoning.
Organophosphate poisoning is poisoning due to organophosphates (OPs). [4] Organophosphates are used as insecticides , medications, and nerve agents . [ 4 ] Symptoms include increased saliva and tear production, diarrhea , vomiting, small pupils , sweating, muscle tremors, and confusion. [ 2 ]
Pralidoxime (2-pyridine aldoxime methyl chloride) or 2-PAM, usually as the chloride or iodide salts, belongs to a family of compounds called oximes that bind to organophosphate-inactivated acetylcholinesterase. [1] It is used to treat organophosphate poisoning [2] in conjunction with atropine and either diazepam or midazolam. It is a white solid.
Atropine is often used in conjunction with the oxime pralidoxime chloride. Some of the nerve agents attack and destroy acetylcholinesterase by phosphorylation, so the action of acetylcholine becomes excessive and prolonged. Pralidoxime (2-PAM) can be effective against organophosphate poisoning because it can re-cleave this phosphorylation.
Atropine is the standard anticholinergic drug used to manage the symptoms of nerve agent poisoning. [14] It acts as an antagonist to muscarinic acetylcholine receptors, blocking the effects of excess acetylcholine. [13]
Common mnemonics for the symptomatology of organophosphate poisoning, including sarin, are the "killer Bs" of bronchorrhea and bronchospasm because they are the leading cause of death, [8] and SLUDGE – salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis (vomiting). Death may follow in one to ten minutes after ...
Poisoning is treated with atropine and simultaneously with oximes such as pralidoxime. [38] Atropine blocks acetylcholine from binding with muscarinic receptors, which reduces the pesticide's impact. However, atropine does not affect acetylcholine at nicotinic receptors and thus is a partial treatment.
The median lethal dose for inhaled A-234 has been estimated as 7 mg/m 3 for two minute exposure (minute volume of 15 L, slight activity). [65] The median lethal dose for inhaled A-230, likely the most toxic liquid Novichok, has been estimated as between 1.9 and 3 mg/m 3 for two minute exposure. Thus the median lethal dose for inhaled A-234 is 0 ...