Pretreatment is not useful against sarin and VX poisoning, because physostigmine is toxic at the

amounts required. Pyridostigmine is the drug of choice for pretreatment with the dosage of 30 mg orally twice daily.76 Medical Management of OP Poisonings Primary Protection and Care The first step in managing chemical victims is that the emergency responders must protect themselves to prevent contamination resulting from contact with casualties and the environment. Initial standard treatment of a nerve agent poisoning includes the administration of atropine to counteract muscarinic over-stimulation, an oxime to reactivate OP-inhibited Inhibitors,research,lifescience,medical AChE, and benzodiazepines to protect against central nervous system seizures.6 This Inhibitors,research,lifescience,medical should be done via an auto injector that is provided for the combatants. Decontamination Decontamination must be performed at the earliest opportunity to limit percutaneous absorption of the agent, and to prevent contamination of the rescuers. Complete decontamination is necessary before patients enter a health care center. Inhibitors,research,lifescience,medical Gastric aspiration and lavage is indicated in case of OP oral ingestion. If the eyes have been exposed,

they should be irrigated as soon as possible with water and saline. Decontamination solutions, which are usually composed of strong alkaline chemicals, are used for efficient detoxification of chemical meanwhile warfare agents.77 Some of the proposed decontaminants are aqueous mixtures (Sandia Foam, Decon Green), organic Inhibitors,research,lifescience,medical solutions (GD5, GD6F, and GDS2000) or sorbent powders (M100).77-80 Recombinant DNA-derived AChE represented a great improvement over wild-type AChE as bioscavengers. Using the cell immobilization technology, compound libraries immobilized Escherichia coli with surface expressed OP hydrolase was made to detoxify nerve agents.81,82 By protein engineering techniques one BChE mutant G117H was

Inhibitors,research,lifescience,medical made to hydrolyze V and G agents but reaction Dacomitinib was too slowl.83 Organophosphate acid hydrolyses (OPAH) from two species of ateronomas were cloned and sequenced to detoxify G agents, which was effective.84 New polymers based on a dimethylacrylamide-methacrylate (DMAA-MA) co-polymer backbone are now available that support both chemical and biological agent decontamination.78 Recently, some decontaminants are dispersed in the form of fog, powder or aerosol produced that exhibit active degradation of VX, G agents and mustard gas (HD) to non-toxic products.85 In case of contact exposure with VX a simple and non-invasive application of cooling have been reported to be dramatically useful.