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

Indexeffects of exposure to nerve agent vapor (table), 169effects of nerve agents in humans (table), 170effects on organs and organ systems, 170–180exposure routes, 168–170eye effects, 170–172fluoride regeneration and, 699general clinical tests, 694general treatment principles, 180–190, 205, 316German production of, 48Germany’s development of, 46–47Germany’s experimental testing on human subjects in concentrationcamps, 105historical background of the use of, 156–158hydrolysis compound assay, 695–698inhalational exposure to vapor, 168–169, 185, 244intermediate syndrome and, 318–319laboratory findings, 662lessons learned from Iran, Japan, and Iraq, 195–197, 223lethality of, 244, 661long-term health effects, 316–322mechanism of action, 156, 159, 204–205, 662median lethal dose, 244methods used to confirm human exposures to nerve agent adductsto biomolecules (table), 701methods used to confirm human exposures to nerve agents viaassay of hydrolysis products (table), 698mnemonic for cholinergic crisis (exhibit), 662molecular models (figure), 166muscle necrosis and, 318nasal effects, 172–173nerve agent antidote kits and pretreatments, 64neuropsychiatric symptoms and, 320–321parent compound assay, 694–695pediatric population effects, 661–667pediatric treatment, 195persistent nature of, 244pharmacology of, 166–168physical properties, 167–168polyneuropathy, 317production during the 1950s, 55pulmonary system effects, 173–174return to duty considerations, 194–195rocket program, 121–122secondary contact and, 244signs and symptoms of mild to severe exposure, 191–194skeletal muscle effects, 174–175, 188skin effects, 169–170, 185–186, 244, 529, 661specific treatment by exposure category, 190–194toxicity of, 661toxicological studies, 322triage considerations, 518, 520–521, 522–523use in combination with other weapons, 244volatility of, 134–135, 168World War II use, 3, 48wound decontamination and, 538Yemen Civil War and, 57Neuroleptics. See Antipsychotic drugsNeuropathology of nerve-agent-induced brain damageseizure-related brain damage, 224–225seizures and status epilepticus, 223–224, 664Neuropeptides and neuromodulators. See also specific agentsincapacitating effects, 420–422Neuroprotectantsclasses of drugs, 226–227gangliosides, 227N-methyl-d-aspartate receptor antagonists, 228–232poly(ADP-ribose) polymerase inhibitors, 227ryanodine receptor antagonists, 227–228Neuroprotection as a treatment for nerve agent survivorsfree radical scavengers, 232mitochondrial permeability transition inhibitors, 232neuropathology and the mechanism of nerve-agent-induceddamage, 223–225neuroprotectants, 226–232“neuroprotection” definitions, 225–226neuroprotective hypothermia, 232relevance of neuroprotection to nerve agent survivors, 225–226Neuroprotective hypothermianerve agent exposure treatment, 232Neuropsychiatric symptomsmustard agent exposure and, 315nerve agent exposure and, 320–321organophosphate insecticide exposure and, 319–320Neurotoxic shellfish poisoningbrevetoxin and, 631treatment, 631Neuve-Chapelle, Battle ofdianisidine chlorosulphonate use, 14Newmark, J.treatment guidelines for children, 195Ni-shells. See Dianisidine chlorosulphonateNicoloau, K.brevetoxin research, 628Nicotera, P.mustard agent research, 265Niebauer, M.dantrolene research, 228Niemann,sulfur mustard synthesis, 260NIMS. See National Incident Management System1920sairplane use for chemical attacks, 26, 118–119Berber war with France and Spain, 42–43Chemical Warfare Service and, 43–44improvements in chemical weapon delivery systems, 118new US policy on chemical warfare, 44–451930sItalian-Ethiopian War, 45–46Japanese invasion of China, 46new chemical agent development, 119new chemical weapon development, 119–120organophosphorus compound development, 46–471940schemical weapon delivery system improvements, 1201950sChemical Corps changes, 54–55chemical weapon delivery system improvements, 120incapacitant program, 55–56Korean War, 54medical research on human volunteers, 55nerve agent production and development, 55Soviet threat, 561960sArab-Israeli Six-Day War, 58Army reorganization, 56–57chemical warfare program changes, 59–60chemical weapon delivery system improvements, 120–122Dugway Proving Ground incident, 59incapacitating chemical agent development, 59Operation CHASE, 59, 60psychedelic agent experiments, 3public hostility toward chemical weapons, 59sarin accident in Okinawa, 59Vietnam War, 57li