Toxic Exposures

Nerve Agents are potent organophosphates initially developed during WW1 by German military. (Tabun/GA, Sarin/GB, Soman/GD and VX) They have since been used in various conflicts and terrorist events including Iran/Iraq conflict, Tokyo subway terrorist event, and in the Syrian conflect. They have varying properties regarding potency, volatility, and environmental persistence. For example, VX is oily with low volatility and high environmental persistence, and is very lethal even with dermal exposure.

Nerve agents, inhibit acetylcholinesterase via an organic phosphorus compound. A reversal agent must be given prior to “aging,” otherwise the phosphorylated enzyme cannot be reversed. Nerve agents have variability in time to “aging.” For example, Soman ages in 2-6 minutes, and VX in 48 hours. Vapor exposure leads to symptoms quickly, while dermal exposure can have delay. Symptoms can include muscarinic symptoms (salivation, lacrimation, bronchorrhea, bradycardia, bronchoconstriction), nicotinic symptoms (muscle fasciculations, paralysis), and seizures.