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