Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Aspects of Chemical WarfareMyasthenia gravistreatment of, 156, 198NN-acetylcysteinephosgene inhalation treatment, 354N-methyl-d-aspartate receptor antagonistsdexanabinol, 229–230dizocilpine, 228gacyclidine, 230ketamine, 230–232memantine, 228–229Nagao, M.sarin research, 699Nakajima, T.sarin research, 695, 696Naloxoneopioid overdose treatment, 418Namba, T.organophosphate insecticide exposure research, 320NAPP. See Nerve agent pyridostigmine pretreatmentNasal effectsnerve agent exposure, 172–173Nasser, Pres. Gamal Abdul (Egypt)Yemen Civil War and, 57–58National Academy of Sciencesanticholinergic deliriant research and, 424causal relationship between lewisite exposure and chronicrespiratory disease, 294National Bio-Defense Analysis and Countermeasure Centerdescription and role, 767National Center for Disaster PreparednessMark I kit recommendations, 663Program for Pediatric Preparedness, 683National Defence Research Institute of Swedenhair specimen analysis for mustard agent, 726National Defense Authorization Act“Defense against Weapons of Mass Destruction,” 128, 754National Defense Strategy of the United States of America, 758National Disaster Medical Systemdescription, 765National Fire Protection Agencylevels of protection, 580National Guarddomestic preparedness role, 763National Incident Management Systemcommand and management component, 756description, 492, 755–756incident-specific resources, 756organizational outline for incident management commandand coordinating centers (figure), 759National Institute for Occupational Safety and Healthlevels of protection, 580permissible chlorine exposure level, 359phosgene limits, 734powered-air purifying respirators and, 5442-chlorobenzylidene malononitrile exposure guidelines, 447,450Working in Hot Environments, 541National Institute of JusticeGuide for the Selection of Chemical Agent and Toxic Industrial MaterialDetection Equipment for Emergency First Responders, 581National Institute of Standards and Technology3-quinuclidinyl benzilate monitoring, 739National Institutes of Healthcarcinogen bioassays on chemical agents, 1341-chloroacetophenone research, 461Project BioShield and, 251National Medical Chemical and Biological Advisory Teamdescription and role, 764National Research Councilacute exposure guidance levels for chemical agents, 143dibenz[b,f]-1,4-oxazepine and, 4671-chloroacetophenone and, 4632-chlorobenzylidene malononitrile gene mutation and, 448National Response Frameworkcoordination guidelines for DHHS, 761description and role, 758National Response Plandescription, 492, 755–756federal department or agency support to state and local governments,758–759integration of the federal government’s domestic prevention,preparedness, response, and recovery plans, 756National Security Strategy of the United States of America, 758National Strategy for Homeland Security, 755, 758National Toxicology Program2-chlorobenzylidene malononitrile carcinogenicity and, 449NATO Handbook on the Medical Aspects of NBC Defensive Operationsmustard agent treatment, 670NDMS. See National Disaster Medical SystemNeostigminedescription, 158tetrodotoxin treatment, 628Nernst, Walther Hermannaccomplishments, 15dianisidine chlorosulphonate development, 13–14, 15, 79, 80Nernst Ni-Shrapnel. See Dianisidine chlorosulphonateNerve agent pyridostigmine pretreatmentdescription, 158dosage considerations, 202Nerve agents. See also Incapacitating agents; Neuroprotectionas a treatment for nerve agent survivors; Organophosphoruscompounds; Pyridostigmine bromide; Treatment of nerve agentexposure; specific agents and types of agentsaccessibility of and ease of manufacturing, 244, 251adducts to biomolecules, 698–701advantages of as a weapon, 126agents included, 661aging half-time of nerve agents (table), 198analytical methods for assay of nerve agent hydrolysis products(table), 697Arab-Israeli Six-Day War and, 58behavioral effects, 175–179bioscavengers, 232, 244–253cardiovascular system effects, 179–180case history: nerve agent exposure in Nazhmar, Iran (exhibit),662case report: accidental exposure of a man to liquid soman(exhibit), 162–163central nervous system effects, 175–179chemical, physical, and environmental properties (table), 167chemical structure (figure), 694cholinesterase analysis, 701–706clinical presentation, 662compared with chlorine, phosgene, and mustard agent, 181compared with commonly used ChE inhibitors, 166–168compared with insecticides, 316–317conventional wounds contaminated with, 522–523definitions of Ct, LCt 50 , and LD 50 (exhibit), 168dermal exposure to liquid, 169–170, 185–186, 244description, 204, 316diagnostics, 693–706effects of dermal exposure to liquid nerve agents (table), 169l