Pretreatment and prophylaxis against nerve agent poisoning: are undesirable behavioral side effects unavoidable?

Author
Myhrer, Trond
Aas, Pål
Date Issued
2016
Permalink
http://hdl.handle.net/20.500.12242/575
https://publications.ffi.no/123456789/575
DOI
10.1016/j.neubiorev.2016.10.017
Collection
Articles
Description
Myhrer, Trond; Aas, Pål. Pretreatment and prophylaxis against nerve agent poisoning: are undesirable behavioral side effects unavoidable?. Neuroscience and Biobehavioral Reviews 2016 ;Volum 71.(December) s. 657-670
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Abstract
The threat of chemical warfare agents like nerve agents requires life saving measures of medical pretreatment combined with treatment after exposure. Pretreatment (pyridostigmine) may cause some side effects in a small number of individuals. A comprehensive research on animals has been performed to clarify effects on behavior. The results from these studies are far from unambiguous, since pyridostigmine may produce adverse effects on behavior in animals in relatively high doses, but not in a consistent way. Other animal studies have examined the potential of drugs like physostigmine, galantamine, benactyzine, trihexyphenidyl, and procyclidine, but they all produce marked behavioral impairment at doses sufficient to contribute to protection against a convulsant dose of soman. Attempts have also been made to develop a combination of drugs capable of assuring full protection (prophylaxis) against nerve agents. However, common to all combinations is that they at anticonvulsant doses cause behavioral deficits. Therefore, the use of limited pretreatment doses may be performed without marked side effects followed by post-exposure therapy with a combination of drugs.
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