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

IndexPersian Gulf War. See also Operation Desert Stormchemical weapons and, 63–65, 106–107“Gulf War” syndrome, 64nerve agent antidote kits and pretreatments, 64, 704PFC David Allen Fisher’s exposure to mustard agent, 106–107pyridostigmine bromide therapy and, 202–204use of 3-quinuclidinyl benzilate by Iraq, 413Pert, Candacemorphine research, 418Pesticides. See Organophosphate insecticidesPetras, J.M.nerve-agent-induced brain damage research, 223PFIB. See PerfluoroisobutylenePharmacology of cholinesterase inhibitorsblood cholinesterases, 161–166cholinesterase in tissue, 158cholinesterase-inhibiting compounds, 158–159inhibition of blood cholinesterases, 164–166mechanism of action, 159–161nerve agents, 166–168Phenethylamine-based psychedelicsdescription and effects of, 418PhenothiazinesLSD intoxication treatment, 417Philippe, HenriChampagne-Marne Defensive and, 30Phosgeneaccidental release of, 134animal studies, 735chemical reactivity, 354combined with chlorine or diphosgene, 341compared with phosgene oxime, 294cysteine adducts, 736development of, 15, 734earliest reported description involving chemical warfare onthe AEF (exhibit), 22Edgewood Arsenal, MD, production, 119France’s weaponizing of, 341Germany’s experimental testing on human subjects in concentrationcamps, 105glutathione and glutathione adducts and, 735–736inflammatory pathways, 350–351inhalation of, 734–735interleukin-6 levels and, 737–738latent period for symptoms, 324–325lethal dose, 735long-term health effects of exposure, 324–326, 354macromolecule adducts, 737mechanism of action, 136, 734metabolism and markers for exposure, 735–737nerve agents compared with, 181nonmilitary uses, 345odor of, 734, 735pathophysiological effects, 348, 349, 734pediatric effects of exposure to, 673physiological responses, 348, 354, 734properties and attributes of (exhibit), 19regulatory threshold limit value, 734replacement of chlorine with, 18small molecule adducts, 736–737synthesis of, 116toxicity of, 734treatment for inhalation of, 354–355, 363triage issues, 521, 522US production of, 117vapor pressure, 734“white star” mixture with chlorine, 19–20World War I use, 2, 19–20, 25–26, 83, 341Yemen Civil War and, 57Phosgene oximebiochemical mechanisms of injury, 294clinical effects, 295compared with mustard agent and lewisite, 261compared with phosgene, 294eye effects of exposure, 295military use, 294patient management, 295properties, 294pulmonary effects of exposure, 295putative mechanisms by which phosgene oxime causes tissuedamage (figure), 294skin effects of exposure, 295pHuBChE. See Plasma-derived human butyrylcholinesterasePhysostigmineadverse effects, 426, 704chemical structure (figure), 198compared with huperzine A, 704deliriant intoxication treatment, 425–426, 523description, 158development and isolation of, 46mechanism of action, 425, 426PCP intoxication treatment, 4203-quinuclidinyl benzilate intoxication treatment, 426Pinacoloxymethyl-fluorophosphonate. See SomanPlasma-derived human butyrylcholinesteraseadministration of, 247advantages for human use, 246–247, 252, 253availability of, 249, 653behavioral safety of, 248–249Cohn Fraction IV-4 paste source, 247, 249, 251compared with fetal bovine serum AChE, 245efficacy of, 247–248, 252immunological safety of, 248, 252pharmacokinetics, 247, 252–253, 702prophylactic dose, 247protection by human butyrylcholinesterase against nerveagent poisoning (table), 252purification from human plasma, 247pyridostigmine bromide and, 251recombinant type, 249–250safety of, 247, 252–253sarin and, 698–699stability of, 247, 252Plasma-derived stoichiometric bioscavengerscholinesterases, 245–247compared with catalytic bioscavengers, 250plasma-derived human butyrylcholinesterase, 245–247Playfair, Lyoncacodyl cyanide artillery shell proposal, 11Point detectorschemical agent detector kits, 576–577improved chemical agent detectors, 576M22 automatic chemical agent detector and alarm, 577M8 chemical agent detection paper, 575M9 chemical agent detection paper, 575–576M272 chemical agent water testing kits, 577Polhuijs, M.sarin research, 696, 698–699Poly(ADP-ribose) polymerase inhibitorssoman-induced seizure-related brain damage treatment, 227Polymer fume feverperfluoroisobutylene and, 358polytetrafluoroethylene and, 345Polyneuropathylv