Acute and long-term consequences of exposure to organophosphate nerve agents in humans

Epilepsia
Taiza H FigueiredoAnn M Marini

Abstract

Nerve agents are organophosphate (OP) compounds and among the most powerful poisons known to man. A terrorist attack on civilian or military populations causing mass casualties is a real threat. The OP nerve agents include soman, sarin, cyclosarin, tabun, and VX. The major mechanism of acute toxicity is the irreversible inhibition of acetylcholinesterase. Acetylcholinesterase inhibition results in the accumulation of excessive acetylcholine levels in synapses, leading to progression of toxic signs including hypersecretions, tremors, status epilepticus, respiratory distress, and death. Miosis and rhinorrhea are the most common clinical findings in those individuals acutely exposed to OP nerve agents. Prolonged seizures are responsible for the neuropathology. The brain region that shows the most severe damage is the amygdala, followed by the piriform cortex, hippocampus, cortex, thalamus, and caudate/putamen. Current medical countermeasures are only modestly effective in attenuating the seizures and neuropathology. Anticonvulsants such as benzodiazepines decrease seizure activity and improve outcome, but their efficacy depends upon the administration time after exposure to the nerve agent. Administration of benzodiazepines may in...Continue Reading

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Citations

Apr 7, 2020·Drug and Chemical Toxicology·Fatemeh SaberiMahdi Mashhadi Akbar Boojar
May 22, 2020·The Journal of International Medical Research·Rajagopalan Vijayaraghavan
Apr 5, 2020·International Journal of Environmental Research and Public Health·Maya Siman-TovBruria Adini
Jun 3, 2021·International Journal of Molecular Sciences·Margarita HerediaAdelaida Sánchez Riolobos
Jul 27, 2021·Current Opinion in Toxicology·Yi-Hua Tsai, Pamela J Lein

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