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Introduction
- Used as pesticides
- Used as weapons (nerve agents)
- Sarin Gas, VX Gas, Novichok
- Transdermal, Inhalation, Ingestion
Clinical Presentation
- Muscarinic Activation (Dumbels Mnemonic)
- Defication
- Urination
- Myosis
- Bradycardia, Bronchospasm, and Bronchorrhea
- “The Killer B’s”
- Emesis
- Lacrimation
- Salivation and Sweating
- Nicotinic Activation
- Muscle weakness and paralysis
- CNS Activation
- Respiratory Depression
- Altered Mental Status
- Seizures
Treatment
- Atropine
- Reverses Dumbels
- Keep giving and doubling the dose until brochorrhea and bradycardia resolve
- Pralidoxime
- Only works before ‘aging’ occurs
- Diazepam
- Stops the seizures
