09.16.2023 - By Zack Olson, MD and Michael Estephan, MD
Introduction
* Used as pesticides
* Used as weapons (nerve agents)
* Sarin Gas, VX Gas, Novichok
* Transdermal, Inhalation, Ingestion
Clinical Presentation
* Muscarinic Activation (Dumbels Mnemonic)
* Defication
* Urination
* Myosis
* Bradycardia, Bronchospasm, and Bronchorrhea
* “The Killer B’s”
* Emesis
* Lacrimation
* Salivation and Sweating
* Nicotinic Activation
* Muscle weakness and paralysis
* CNS Activation
* Respiratory Depression
* Altered Mental Status
* Seizures
Treatment
* Atropine
* Reverses Dumbels
* Keep giving and doubling the dose until brochorrhea and bradycardia resolve
* Pralidoxime
* Only works before ‘aging’ occurs
* Diazepam
* Stops the seizures