#pralidoxime

[mcatmemoranda]

Most cases of severe organophosphate poisoning will require supportive care with intravenous fluids and respiratory support. The underlying toxicity is reversed with atropine (muscarinic antagonist) and pralidoxime (activator of cholinesterase).

[anchorwindlass]

Dalam Kenangan.-

Jika memang ragaku tak bisa mendekapmu seutuhnya, maka biarkan rasa ini terpatri secara abadi dalam sajak sajak indah yang bisa di saksikan banyak jiwa ; bahwa aku benar benar dan akan selalu mencintaimu, dengan sangat. – Samudera Hindia, 4 Juli 2022.

Counting seconds before my homecoming…

Pretensius cermin perak nan elok  teragitasi dalam sosok parlente yang rupawan, mendaulat yuridiksi flamboyan yang otentik. kilap mata sendu yang berbisa lantas menggendam preservasi gersang sang juvenil yang sedang fluktuatif  dilucuti romansa.

Sayap sayap cendayam trengginas menggalang proteksitas, memayungi substansi moderat yang krisis afirmasi. Terali berduri secara inheren menganeksasi friksi friksi aforisme yang runyam.

Semata wayang di runjam, terbit gerangan untuk membetas. Kausa yang di rambati interelasi arteri terasa stagnan, pasung iblis yang ia sumpah serapahi tak piawai ia jeda. lasat ia tertawan, berlipat ia kasmaran.

Macam mana bisa engkau laksana pralidoxime sekaligus organifosfat novichok yang secara sukarela ku  kehendaki sekaligus? Patois menyarapahi pencipta hidup atas renjana yang ia perkenankan. Mengapa secara serakah bisa ia hipotekkan segenap juwita ini untukmu?

Mencumbui setiap riak arus di pantaimu, puncak ngarai di lembahmu sementara guruh rinai saling berkelahi di langitmu yang kelabu. Sesendu inikah terminasi dari narasi yang di dominasi elegi?

Secara definit rengkuhan meradang menyambung ruang. menganyam saban resonansi provisional memanifestasikan sendyakala dalam risalah senduku. Se-absah apapun intensi ingin mengandaskan biduk untuk bersedia merelakanmu, tak jua jadi inkarnasi.

Jika bertaut dengan dermaga secara lengkara mempertuankan nuraga, bolehkah sedari awal aku menolaknya? Pararelisme merekonsiliasi, kolateral menyeparasi.

Tak semestinya ku pinang komposisi kronis kisah infinit dalam prasangka, sedangkan kau represi sekelumit arunika dengan rahara yang harus kau celik dari riuh saujana. Jika prosamu terselarung bercak abtar, usah lilit daku untuk melayur juga di gelegaknya.

Dakwamu bak traktat putih laksmana yang mendedikasikan suratan pada shinta secara permisif tak abusif tanpa terbersit vitalitas untuk mendaulat konfigurasi sang rama.

Kau laksana gejolak kirana yang membara sedang daku adalah komponen oktan delapan yang merana. Jika dengan menghantam karma dan menggugat takdir parokial kita bersintesis untuk menggalang inkorporasi cendawan, apa yang akan kau tumbalkan sebagai agunan? Sayang, kita segera meledak.

Deklamasi rindu calar sudah menjadi fragmentasi dari debu.

Deklarasi nan manis berhijrah sudah menjadi cabikan rasa yang skeptis.

Deaneksasi paripurna penuh cinta tenggelam sudah menjadi getir yang tak terhingga. 

Kau adalah arestasi paling sempurna yang secara persisten selalu menyulut takjub. Bias mata mempersunting tenang menuju tempat pulang yang sampai kapanpun tak akan piawai daku pandang.

Sudahi balada yang meyesakkan dada dengan janjikan daku kebahagiaanmu selalu yang sudah daku tukar dengan ikhlas ini.

Arah nadir yang akan selalu menjadi titik zenith tak sampai dalam celestial meridian ku.

Sedu teramat solider yang secara sudi ku kenankan dengan masif.

Maka mengudaralah dengan semampai, sayang. hingga cakarmu melukai mayapada, taringmu memapas dirgantara. Terbanglah di antara gegana yang melerai gempita. Demarkasilah khayanganmu dengan jingga atau ungu. Daur ulang bara dongengmu dengan wiracarita kemenangan. runyam sudah andaikan bercempera.

Sadar ku  mencintaimu sialnya, dengan sangat. Kendati, terimakasih menyetarai konkordansi dari akhir relevansi ini.

Engkau adalah segala ketidakmungkinan yang akan selalu ku semogakan.

“Bahagiamu selalu” ucapmu. bagaimana bisa, sedang bahagiaku adalah engkau?

menghunus cenangkas melerai predestinasi dengan lenggana. Setelah konstan mengintimidasi takdir, komitmen serupa pelunas sembilu, tiada bukan untuk memelukmu.

Sungguhpun rentang detik sedia menjadi restorasi luka ini sementara kau beranjak. Tarum kontemplasi telah kau tuliskan atas eksemplar kritis nafasku. selamanya, walaupun sewajarnya.

Rencam gerhana akan mencagari matahariku yang terbit dari utara. berkenankah kau ulang lucuti ratapan gundah durjana melalui geletar manis bergala?

Sebagai konklusi, Sampai jumpa, dengan parafrasa yang istimewa.

Se-sentimental mungkin palingkan daku secara konstituen dan tinggal landas.

Desakku langkas segera sirna, walaupun aku tersiksa.

merdeka tak tertunda.

Hatiku, milikmu.

Walau akhirnya kau sepah jua.

[mar-sibilina]

Mom: He’s been on this medication for over an hour. Chase: Pralidoxime is very effective; it just takes a little time for it to kick in. Mom: Maybe you're wrong; maybe it’s not a pesticide.

[macgyvermedical]

NERVE AGENTS

WARNING: This post is about chemicals frequently used in acts of war and terrorism- particularly acts that have recently made headlines and been a very real, terrifying, and deadly part of people’s lives and news cycles. This post does not explicitly reference any particular real-life attack. That being said, it does present information aimed at writing the human response to exposure to nerve agents in a fictional and/or whumpy context, and does mention several uses of nerve agents in fiction. If you’re not comfortable with reading about such things, or don’t feel comfortable reading them in those contexts, feel free to keep scrolling- if you do want to read it, the rest of the post is below the cut.

Guys, I am on so many lists now. Like so many. I have googled so much sketch stuff for this blog I’m going to have to ask my sister to order a new humidifier for my snake’s tank because if I order one on Amazon the NSA is gonna send a SWAT team to my apartment... But anyway...

It’s been a while since Hawaii Five-0 S1E23 “Until the End is Near” premiered, and yet there’s a gifset that hasn’t stopped circulating in the whump community: one of Danny Williams, struggling to breathe, sweat covering his face, sliding slowly down a stone wall as the rest of the team runs towards him in panic. Later in that episode, it would come out that Danny ingested (or rather absorbed through skin contact with the episode’s victim) sarin, a chemical weapon well known for its longstanding applications in war and terrorism. 

What "Nerve Agents” Are:

As explained in the episode, sarin belongs to a group of chemicals known as nerve agents. Medically, nerve agents are called acetylcholineseterase inhibitors. Some common ones include:

“G-Series”- These were pre-WWII-era, and probably the most well-known nerve agents. They were originally invented as highly-effective pesticides, but were realized as chemical weapons when the scientist and lab assistant testing tabun both accidentally came into contact with less than a drop and became severely ill for several weeks.

Sarin (GB

Tabun (GA)

Soman (GD)

“V-Series”- These were invented during the Cold War for the express purpose of creating chemical weapons. They stick around in the environment for longer without degrading than G-series agents, making them more useful as weapons. The most well-known is denoted “VX,” but there are many others named with “V’ and then a second letter.

Organophsphate Pesticides- today in the US, about 50% of pesticides can double as nerve agents. They come in very dilute concentrations and degrade very quickly, making them less useful as poisons. However, farm workers with long-term exposure have had significant health problems as a result. In fiction, the pilot episode of Royal Pains features a case of organophosphate pesticide poisoning, and (though this is not explicitly stated) Mac is poisoned by some variety of these in the MacGyver episode “Bitter Harvest”. The most well-known of these include the substances malathion and parathion. Since 2001, it has been illegal to use these substances in residential areas in the US because they tend to stick around in the environment long enough to potentially harm humans. They also reek.

How They Work:

Normally, when the brain wants something done in the body, it sends a signal via nerve to the muscle, gland or organ responsible for it. The end of that nerve then releases a neurotransmitter, and molecules of that neurotransmitter bind to receptors on the tissue, triggering the intended effect. When the job is done, the excess neurotransmitter is either slurped back up and recycled for next time, or degraded by an enzyme so it can’t hang around and make stuff happen when it shouldn’t.

There are many neurotransmitters in the human body, but the most important one for this post- and one of the most active in the body- is called acetylcholine. Presence of acetylcholine at receptor sites triggers secretion of mucous, tears, and sweat, causes muscle to contract, modulates memory and attention, and helps control digestion. Now, in order for these things to happen correctly, only very precise amounts of acetylcholine can be available to the receptors for very precise amounts of time. Once acetylcholine does its job, it immediately gets broken down by an enzyme called acetylcholinesterase.

This acetylcholinesterase stuff is super important. If is didn’t exist, or was, say, inhibited, acetylcholine would just hang around and build up in the areas where it does its work. This would cause all those things above to happen continuously and inappropriately. Which is exactly what happens when nerve agents, which are, as I said, very potent acetylcholinesterase inhibitors, end up in the human body.

What They Do:

People (and by extension characters) unlucky enough to be exposed to a nerve agent will typically show symptoms of severe acetylcholine poisoning. “Classic” symptoms include:

Pupil constriction

Headache

Difficulty breathing (from contracting muscle and excess secretions in lung passages)

Profuse sweating

Weakness

Excess tear formation

Fasciculations (muscles contracting inappropriately)

Nausea/vomiting/abdominal pain/diarrhea

Urinary frequency/incontinence

High heart rate and blood pressure

Higher doses will show symptoms progressing to:

Seizures and coma

Paralysis

Low heart rate and blood pressure

Respiratory arrest

Most people end up dying from paralysis of the respiratory muscles.

How quickly symptoms show up has to do with how the chemical got into the body- breathing a nerve agent may cause the onset of symptoms almost immediately, while absorbing it through the skin can delay onset of symptoms up to 18 hours.

How They’re Used:

Nerve agents are colorless liquids that can enter the body by ingestion (eating or drinking a substance containing them), absorption (through skin, eyes or mucous membranes), or inhalation (breathing a vapor or gas).

While nerve agents are poisons and can certainly be used to target a specific individual (as in the H50 episode), they are particularly well-suited to war and terrorism because of the ability to poison many people at the same time- and poison them quickly and repeatedly.

Spread by aerosol, they can persist in an environment (and continue killing people) for up to three days (three days in colder, wetter environments- in hotter, dryer environments they may last less than 24 hours). 

Only a very, very small volume of any nerve agent is required to kill a person. A normal-sized drop of sarin placed directly on skin (and not washed off) is more than enough to kill an adult. If breathed, death requires considerably less.

Surviving Them:

If your characters have no access to drugs, people can survive very small exposures without them- particularly skin exposures. Since the main deadly issue is respiratory arrest, getting control of their airway and forcing air into them is probably the most important intervention (I say “forcing” because given the airway constriction and the excessive secretions, this won’t be easy. Like, good luck if they’re not intubated).

After their airway and breathing is taken care of (if you have to get to circulation, meaning CPR, its too late in a mass-casualty/drugless situation, but that’s a whole other post), getting them cleaned off is really important. This is both to protect people taking care of them, and to make sure they don’t continue to absorb the agents. Nerve agents degrade when exposed to alkaline solutions, so plain old soap and water (or bleach) works pretty well as a decontamination solution.

Now, if they do have access to drugs, the above holds true, but...

In the H5-0 episode, Jenna tells Steve that Danny needs a drug called pralidoxime in order to survive. Pralidoxime is a nerve agent antidote that works by chemically reactivating the inhibited acetylcholinesterase. Unfortunately, it only works if given within a specific time frame after exposure (2 minutes for soman, 5 hours for sarin, 13 hours for tabun). Pralidoxime also doesn’t work immediately, so other drugs must be given to mitigate the effects of the nerve agent and keep the person alive until the reactivated enzymes can bring acetylcholine down to safe levels.

The first drug given for this is atropine. Atropine works by blocking some of the acetylcholine receptor sites. If there’s only a few receptor sites available, it matters less how much excess acetylcholine is around because it can’t do as much harm.

Another drug given is diazepam. Diazepam can stop or decrease seizure activity related to nerve agent exposure. Like atropine, it is not an antidote, but it can help manage life-threatening seizures until the pralidoxime works.

Now, none of these drugs can be effectively given orally. They’re best given IV, but since the poison works so fast, most people don’t have time or resources to start an IV to administer them. The solution to this is the “Mark 1 Kit”- a case with two auto-injectors (think epi-pens), one containing pralidoxime and the other containing atropine (this was the type of kit featured in the Royal Pains episode mentioned above).

The auto-injectors are designed to be given simultaneously or one immediately after the other, as soon as possible after symptoms appear, by the exposed person if at all possible (one of those “help yourself before assisting other passengers” things).

Another type of kit is also available, called the duodote, and contains both drugs in one auto-injector. Duodote kits are also available in bulk for response to mass-casualty events. Though specific drugs carried in the national stockpile are not published publicly, pralidoxime, atropine, and diazepam are likely included.

As it stands, Ambulances (and, I’m assuming law enforcement vehicles??) in major US cities carry Mark 1 or duodote kits for the medical and rescue personnel serving inside them. Military personnel serving in areas where nerve agent attacks are a potential hazard may carry up to three. In the case of an attack, if exposed and symptomatic, rescue personnel can self-administer the kits, or provide “buddy aid” to unconscious personnel. These kits are not for use, typically, by civilians. 

Note that people do not get immediately better when treated. These are primarily life-saving drugs, and repeated doses and medical care may be needed for weeks to months after.

Protecting Against Them:

For your characters who may be called into service to respond to a nerve agent attack (or who may be going in after a character exposed to nerve agents), there are a couple of options for keeping them safe(r).

There are a few options for detecting nerve agents in the environment. These range from “M8″ or “M9″ paper pads (which detect agents by changing color when exposed), but that only work on liquids, to more sophisticated and very expensive machines that pull air through special detectors that can identify chemicals that have been vaporized or turned into gas. 

Currently, “Level A” personal protective equipment is recommended by OSHA for any potential exposure to nerve agents. For reference, that’s this snazzy suit:

In addition to this (or instead of, if your characters are feeling lucky), there is a chemical option for preventing nerve agent poisoning. A drug called butyrylcholinesterase is currently in development to bind any nerve agent before it has the opportunity to cause problems in the body. This could be given to law enforcement, medical, and rescue personnel in the event of a nerve agent attack where they would need to be fit enough for duty to respond and have a high likelihood of becoming exposed.

[Patreon] [Fiverr]

[bethiniancorpuscle]

Basic pharmacology of neuromuscular junction

ACh acts on N2 receptors (ligand-gated Na+/K+ receptors)

Block Na+ channels that propagate nerve impulse - local anaesthetics (lidocaine), tetrodotoxin

Inhibit ACh release - tetanus toxin, botulinum toxin

Competitive antagonists - vecuronium

N2 agonists - suxamethonium

Flaccid paralysis

Only cleared by plasma cholinesterase

Reversible anticholinesterases - edrophonium, neostigmine, physostigmine

Block activity of AChE

Diagnose and treat myasthenia gravis and treat glaucoma respectively

Irreversible anticholinesterases - organophosphates (pesticides, nerve gases)

Long-lived flaccid paralysis

Treat with pralidoxime within 10 minutes - cleaves OP-AChE complex

[theundercovermarvelfan]

Whumptober 2020 - Day 22

Whumtober Challenge @whumptober2020

Day 22 Do These Tacos Taste Funny To You? Poisoned | Drugged | Withdrawal

“Alright, team, I think it’s safe to say this is a dead end,” Tony announced as he glanced around the empty room in the compound they had been searching. “What do you say, we call it a day?”

“I think Tony’s right,” Steve agreed into his comm. They had split off into two teams, with him and Tony searching one wing of the compound while Natasha and Clint searched the other. “This place has been abandoned for years. Looks like we got a bad lead. Meet back here and we can head out.”

“Sounds good,” Natasha agreed over the line. 

“Roger, Rogers,” Clint said with a laugh. “Heading your way.”

A few minutes later, Natasha strode into the room where Steve and Tony were waiting from a door on their left. 

“Where’s Clint?” Steve asked, confused. 

“We split up to cover more ground,” Natasha said. “He should be here in a minute.”

“Any day now, Barton,” Tony said into the comm. “I’m getting hungry. I’m thinking we hit a drive-thru on the way home. You can fly the Quinjet through one of those, right?”

“Don’t tempt me, Stark,” Clint said with a laugh.

“Seriously, though, don’t tempt him,” Natasha said as she glared at Tony. “He’ll actually try it.” 

“Killjoy,” Tony said, but everyone could hear the smirk in his voice behind his faceplate.

“Alright, I’m here,” Clint announced as he appeared just on the other side of a doorway over to their right, grinning mischievously, as if he were already thinking about how he could get a jet into a drive thru. “Let’s get--”

The moment that Clint passed through the doorway, an explosion of yellow tinted gas suddenly shot out of the doorframe, instantly filling the space. It happened so quickly, no one had time to really react, and it wasn’t until Clint was screaming that any of them understood what was happening. 

“Clint!” Natasha yelled as she lunged forward, only to be caught around the middle by Steve and pushed back toward Tony. 

“Get her out of here!” Steve roared at Tony. “I got Clint!” 

Because poisonous gas triggered by a booby trap didn’t stay in one place. It spread. 

As Tony’s suit whirred to life, grabbing Natasha and jetting to the nearest exit, Steve ran forward. He was much less affected than most when it came to things like poison, but even he could feel a stinging sensation prickling his skin as he leapt into the yellow tinted air still hanging in the doorway. Clint had dropped to his knees, jerking wildly as he yelled out in agony, completely oblivious to anything else going on around him. 

Steve quickly scooped up Clint in his arms and then turned and ran as fast as he could, not stopping until they were back outside. 

“Clint!” Natasha gasped as she and Tony ran over to where Steve had stopped and carefully lay Clint down in the grass in order to assess his condition. 

“Stop, don’t touch him,” Steve warned, throwing out an arm to stop Natasha’s approach. “It’s some kind of nerve agent, he could still have residue on his skin and clothes.” He had seen this before back in the war. “Bruce--”

“He’s already on his way,” Tony said quickly. 

Clint didn’t appear aware that they were there. He wheezed and coughed horribly as his body twitched and jerked on the ground. Even Steve was coughing on whatever poison they had been doused with, his skin still feeling itchy and uncomfortable. That spoke to how powerful the poison in the gas really was. 

“Bruce, how far out are you?” Steve demanded over the comm.

“Two minutes, max,” Bruce panted over the line. “I’ve got my med bag, I’ve got something to counteract the nerve agent in it.”

“Okay, hurry,” Steve said anxiously as they were all forced to stare down at Clint, still in clear agony as he curled in on himself, wheezing desperately for breath. 

If his airway was compromised…

“I’m here!” Bruce huffed only a minute later as he ran around the corner. He dropped to his knees about a foot away from Clint, swinging his med bag around and immediately digging around in it. “Here, inject this into his thigh,” Bruce said, thrusting and autoinjector to Steve, who followed the orders without question or hesitation, jamming it into Clint’s outer thigh. Clint barely seemed to notice as he continued to jerk and spasm painfully. “Now this one,” Bruce said, holding out another autoinjector. 

This time, as Steve jammed it into Clint’s thigh, the arched suddenly jerked upward, heaving in the first deep breath since the gas had hit him. He felt back to the ground, his muscles still spasming, though not nearly as violently as before. He was still gasping for breath, but it didn’t sound nearly as painful or panicked as it did. 

“Clint?” Steve said. 

“Holy… shit…” Clint gasped breathlessly. 

Steve let out a relieved sigh as he sat back on his heels. “Thank god.”

“What did you give him?” Tony asked. 

“The first injection was atropine and the second was pralidoxime chloride,” Bruce said. “Both are needed to counteract any kind of nerve agent. Steve, I need you to carry him back to the Quinjet, since you’ve already been exposed. We’ll need to put you both through a decontamination protocol.” He eyed him as Steve let out a dry cough. “I might give you a dose back at the jet, just to be on the safe side.”

Steve nodded. “But Clint will be okay?”

“He may need another dose back at the jet… but yes, he should be okay,” Bruce assured them. 

“Never a dull moment,” Tony said with a weary sigh.

[pollylynn]

Title: Antiquated WC: 800

Everything about this is uncomfortably old school. Pralidoxime. Atropine. These are names he knows, not bleeding-edge drugs of the future that just might give him super powers. And the egg noodle–wide rubber band that the mute, nameless tech used to take his blood, Goldberg uses now to find a vein in the opposite arm—these are familiar, too. Even the single-use syringe, complete with fingernail tap to send the bubble plunger-ward, has a Marcus Welby, M.D. vibe he wishes he didn’t recognize. 

He emerges from the close confines of the interrogation room—not so different from the box he knows so well from the twelfth—into the humming, slick-surfaced nerve center that the various teams use, and feels a flare of rage, frustration, betrayal. These are exactly the halls of tomorrow he once spent more than a decade writing about. This is the rightful home of Derrick Storm and all the coolest toys, and they have, apparently, nothing to offer him. 

Her words come back to him. The elevator—God—just a few weeks ago. Before the whole world tilted on its axis: Because in my experience huge bureaucracies don’t act with that kind of efficiency. He resents the truth of it now. He hates the truth of it, but that’s the opposite of helpful. So he returns to what he knows. He tries not sneer at what’s clearly a going-nowhere promise from Villante about contacts and the Pentagon. He goes old school himself, returning to what he’s learned from her about tedium and tenacity and sheer effort: You could also check Bronson’s phone records.

And they have their lead. And it’s something. 

But she goes without him. She has to go without him, and he has to stay behind, even though he thinks they’re absolutely the two people here most capable of conducting a successful, old school interrogation, given that Villante—even Villante—hadn’t managed to pull the word Dreamworld out of him. 

Still, she goes without him. She comes back, and the only thing they have hinges on Dreamworld and he’s lost. He feels absolutely lost when Toccata and Fugue in D-Minor startles him from the depths of his own pocket, and he wonders what kind of operation they're running here. 

He feels strongly that his mother, of all people, should not be capable of infiltrating—even by phone—a facility that deals in matters vital to national security. He feels strongly that Goldberg, if he is going to make house calls and carry an absolutely ancient leather doctor bag—the kind that has one of those gaping hinged mouths—should at least have the courtesy to have some kind of mid–twentieth century bed side manner. He feels strongly this should all be significantly less old school than it obviously is.

But old school is what they’re stuck with, and there’s a moment—a centering, peace-granting moment of grace—when he turns a corner. He believes in his heart of hearts that old school might save him. 

They’re gathered around one of the big tables. Waqas Rasheed has given them nothing, because he has nothing to give, beyond a narrative so strange it has to be believed. An old-school raid of the man's apartment has yielded nothing. 

He thinks back to his promise to Alexis that he’ll be home tomorrow morning. He retreats into details—into the logistics of how that will happen if he dies here in DC. He wonders, panic rising, what will become of the wishes he has spelled out, now that his body is riddled with a classified toxin. He wonders what has become of Bronson’s already, what they'll have told Jeanette Miller, if anything. He is on the verge of surrender—absolutely surrender to misery and anxiety—when Kate invokes the the power of story. 

No, Castle. Not nothing, she says with a determined little smile.

She spells it out, just like he usually does. Just like he might have the strength to do if he weren’t dying. She glances at him as if to ask if she's doing okay—if she’s gotten it right, and she has. She’s doing brilliantly, and she's right: It comes down to the story, the missile strike, Bronson, the man on the ground and the body. 

He thinks, with a pang, of Roy Montgomery. Of his hubris lecturing a man who had spent thirty years speaking for the dead on the universals of murder. All mysteries are the same. Motive, opportunity, cover-up, conscience.

He thinks, with hope in his still-beating heart, of how many times they have done it this way. He thinks of her, the story, and the two of them together. 

They’re kicking it old school, and it just might save him. 

A/N: It’s the doctor bag. Hmmm. 

Images via homeofthenutty

[step2ckmap]

Cholinergics

Atropine ↓Ach

Anticholinergic

Bradycardia

Organophosphate poisoning

Pralidoxime ↓Ach

Cholinesterase reactivator

Organophosphate poisoning

Oxybutynin ↓Ach

Anticholinergic

Urge incontinence

Benztropine ↓Ach

Acetylcholine receptor antagonist

Parkinsons disease

Extrapyramidal side effects of antipsychotics

Pyridostigmine ↑Ach

Inhibits acetylcholinesterase

Myasthenia Gravis

Neostigmine ↑Ach

Inhibits acetylcholinesterase

Myasthenia Gravis

Ogilvie syndrome

Urinary retention

Donepezil, Rivastigmine ↑Ach

Inhibits acetylcholinesterase

Alzheimer dementia

[deine-krankenschwester]

PHARMACOLOGY Antidotes

Coumadin- Vitamin K

Benzodiazepines- Romazicon (Flumazenil)

Magnesium Sulfate- Calcium Gluconate

Heparin- Protamine Sulfate

Tylenol- Mucomyst

Opiates- Narcotic analgesics, heroin morphine, Narcan

Cholinergic Meds- Atropine, pralidoxime (2-PAM)

Digoxin- Digiband

Acetaminophen- n-Acetylcysteine

Iron- Deferoxamine

Alcohol withdrawal- Librium

Anticholinergics- Physostigmine

Beta Blockers- Glucagon

Methotrexate- Leucovorin

Anticoagulants- Vitamin K, FFP

Aspirin- Sodium Bicarbonate

CCB- Calcium, glucagon, insulin

Cyanide- Tydroxycobalamin, sodium thiosulfate

Hydroflouric acid- Calcium gluconate

Insulin- Glucose

Isoniazid- Deferoxamine

Methanol- Ethanol

Ethylene glycol- Fomipizole, ethanol

Metheglobin- Methylene blue

Tricyclic antidepressant- Sodium Bicarbonate

[advokat-kiev]

☝🏻ЦПД при РНБО підтверджує, що кожного дня з'являється дедалі більше підтверджень намірів рф застосувати отруйні речовини проти України. 🔺Спеціалісти з InformNapalm повідомляють про можливе використання зарину (з військовою метою його застосовують як бойову отруйну речовину нервово-паралітичної дії) у тих містах, де окупанти не можуть прорвати оборону. ❗️Факти від розвідки InformNapalm: 1. 17-го березня офіцери рф, які воюють в Україні, отримують ін'єкцію Pralidoxime (антидот фосфороорганічних сполук) 2. 20 березня командний склад зс рф отримав ампули з атропіном (антидот при хімотруєннях) 🔺Також окупаційна пропаганда поширює наративи про «американські біолабораторії в Україні» та «витік патогенів» звідти. ❗️Нагадаємо: рашисти вже використовували фосфорні боєприпаси у Попасній. ❗️Нещодавно на Сумихімпром стався витік аміаку. 🔺Ми не можемо уникати такої кількості поширюваної дезінформації. Та сподіваємося, що це лише вигадки хворої фантазії рашистів. #stoprussia https://www.instagram.com/p/Cbhy6D-gbOe/?utm_medium=tumblr

[healthcare-market]

Antidotes Market : Global Industry Revenue and Share by Manufacturers

Antidotes are medicines, chelating drugs, or pharmaceutical ingredients that neutralize the effect of poison or another drug. Paracetamol poisoning is the major concern all over the world as it is the most common drug taken in intentional overdose. Opioid poisoning, cyanide poisoning, benzodiazepine poisoning and other toxins can be neutralized using antidotes. Different types of antidotes are available to neutralize the effect of one particular drug and to reduce the toxicity of many drugs. There are antidotes that are 100% effective, while some can cause fatalities. Examples of antidotes are pralidoxime for poisoning by anti-cholinesterase nerve agents, naloxone for opioid overdose, methylene blue for drug-induced methemoglobinemia, flumazenil for benzodiazepine overdose, dimercaprol for arsenic, gold, or inorganic mercury poisoning, digoxin immune fab for digoxin toxicity, atropine for organophosphates and carbamates, activated charcoal for most poisons, and acetylcysteine for acetaminophen poisoning.

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According to the World Health Organization (WHO), over 5 million people across the world suffer from snake bites each year, and nearly 100,000 of these develop severe sequela. Mortality rate in developing countries in Asia Pacific such as India was approximately 30,000, whereas in developed countries in North America such as the U.S. it was 50,000 cases of bites, of which 7,000 were by venomous snakes.

Increase in awareness and studies regarding the identification of toxins of venomous bites by companies and governments to increase the knowledge of antidotes and drugs is projected to drive the global antidotes market during the forecast period. Rise in prevalence of the medical conditions associated with antidotes such as trichotillomania, toxoplasmosis prophylaxis, smoking cessation, reversal of sedation, reversal of opioid sedation, pneumocystis pneumonia prophylaxis, and opioid overdose drives demand for antidotes. However, rise in prices of anti-venoms is anticipated to restrain the global antidotes market during the forecast period.

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The global antidotes market can be segmented based on antidote type, dosage form, mode of action, and region. In terms of antidote type, the market can be categorized into chemical antidotes, physical antidotes, and pharmacological antidotes. Based on dosage form, the global antidotes market can be bifurcated into oral and injectable. Oral dosage can be divided into capsules or tablets, and syrup. Based on mode of action, the market can be segmented into poison, drug, and toxin.

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Geographically, the global antidotes market can be segmented into Latin America, Asia Pacific, Europe, North America, and Middle East & Africa. North America held the largest market share in 2016, due to increase in research and development on antidotes in the region. Europe held the second largest market share in 2016, due to technological advancements in antidotes. The market in Asia Pacific is anticipated to grow at a rapid pace during the forecast period owing to increase in prevalence of medical conditions associated with antidotes such as nerve agent poisoning, methotrexate rescue, methanol poisoning, mercury poisoning, lead poisoning, and gold poisoning. The market in Latin America and Middle East & Africa is anticipated to be driven by rise in government initiatives regarding antidotes.

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Key players in the global antidotes market include ADAPT Pharma, Inc., Baxter International, Inc., Cumberland Pharmaceuticals, Inc., Meridian Medical Technologies, Inc., Graceway Pharmaceuticals, LLC, Luitpold Pharmaceuticals, Inc., Novartis AG, Protherics, Inc., ApoPharma USA, Inc., Apotex, Inc., and Spectrum Pharmaceuticals, Inc.

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[biomedres]

Organophosphate Pesticide Exposure and Glucose Homeostasis - BJSTR Journal

Organophosphate Pesticide Exposure and Glucose Homeostasis by Mya Thanda Sein* in Biomedical Journal of Scientific & Technical Research https://biomedres.us/fulltexts/BJSTR.MS.ID.002525.php Present review discusses the organophosphate (OP) pesticides toxicity with associated hyperglycemia in animal as well as human studies and effect of OP pesticide on liver enzymes involved in glucose homeostasis pathways. Pancreas keeps hormonal control of glucose homeostasis by secretion of glucagon and insulin. Insulin resistance is higher risk of impair glucose homeostasis. Based on cumulative evidences, oxidative stress induced by OP pesticides may lead to disturbance of glucose homeostasis. There is increasing interest in environment pesticides exposure can affect the glucose homeostasis.Organophosphate (OP) compounds have been used as pesticides since 1975. OP insecticide compounds are a diverse group of chemicals. This compound contains different group of chemicals such as acephate, diazinon, dimethorate, parathion, phosmet, malathion, parathion, diazinon, fenthion, dichlorvos, chlorpyrifos, ethion, azamethiphos [1]. There is emerging evidence that OP has various toxicities such as neurotoxicity, endocrine toxicity, immunotoxicity, reproductive toxicity, genotoxicity and cellular oxidative imbalance and impaired glucose homeostasis at the hazard of human and animal health. It was found the notable coincidence of occurrences in association between OP poisoning and severe hyperglycemia.Two patients, mother and son presented with many complicated symptoms including hyperglycemia and administration of pralidoxime (AChE activator) normalized blood glucose level. Though acetylcholinesterase enzyme level had not been detected in these patients, they had history of exposure to malathion sprayed in their area [2]. Many case report studies had described the detail sign and symptoms of OP pesticide poisoning accompanying hyperglycemia. Then , it has been raised awareness of association between OP poisoning and severe hyperglycemia in human.   For more articles on Journals on Emergency Medicine please click here bjstr Follow on Twitter : https://twitter.com/Biomedres01 Follow on Blogger : https://biomedres01.blogspot.com/ Like Our Pins On : https://www.pinterest.com/biomedres/

[macgyvermedical]

MacGyver Reboot “CD and Hoagie Foil” A Medical Review

Okay so I’m finally sitting down to review the most recent whumpy episode of the MacGyver reboot “CD and Hoagie Foil.”

While its emotional whump all around in this episode- including Mac’s dad story and Riley’s dad story and Bozer’s interrogation- the major physical whump burden is placed squarely on MacGyver’s shoulders.

If you haven’t seen the episode, this is the last stop before major spoilers. 

Here goes- The story centers around a stolen canister of VX nerve “gas.” The “gas” is very deadly, and the bad guys are about to release it into the New York County water supply. Mac is able to steal it before they follow through, but in the ensuing hailstorm of bullets, the canister cracks, and Mac is immediately exposed. In an attempt to contain the spreading “gas,” Mac quickly locks himself in a small office with the leaking canister. Although the action probably saves many lives, it means Mac has to act quickly in order to save his own.

In order to buy himself time, he stabs himself in the leg with a pair of scissors to force his body to release adrenaline. Then, time bought, he builds a fan to draw the “gas” into the sewer gas disposal line, where it could be burned, degrading its effects and preventing everyone from being poisoned. “Gas” now safely out of the office, Mac stumbles out, to be assisted by Cage and Jack as Mac declares that he has only 18 hours to live unless he gets to a hospital very quickly.

Let’s start by talking about VX. I’m not going to go too far in depth about nerve agents as a whole (you can read about them here), but VX is a little different than the others, so I want to go into some detail.

VX is a real-life chemical weapon. It was first created during the Cold War, and was the prototype of the “V-Series” class of nerve agents developed specifically for use in warfare (earlier “G-Series” agents were used in chemical warfare during WWII, but they were originally developed for use as pesticides). The V-Series as a whole is largely classified, but details about the prototype VX was made public in order to provide rescue and medical personnel with a frame of reference in the case of an attack.

VX is a thick, oily, amber liquid, specifically engineered to stick to a person and spread around (to, say, helpful friends or rescue workers) without being easily decontaminated. Due to this, it is most often absorbed through the skin, but it can also be ingested (eaten or drunk), or aerosolized and absorbed through the nasal/oral mucosa or (most dangerously) through lung passages.

VX can kill by any of these routes- requiring only about 10mg to make its way into the body to be lethal (this is the LD50. In comparison, the G-Series agent Sarin has an LD50 of 1000mg).

VX (and, really, all nerve agents) work by blocking the breakdown of acetylcholine (ACH), a neurotransmitter responsible for muscle contraction and tear, mucus, and sweat production. Too much ACH in the wrong places causes muscles to contract inappropriately- the most dangerous side effect of this is that the smooth muscle tissue in the lungs contracts, dangerously narrowing breathing passages (bronchoconstriction), while at the same time ramped up mucus production further limits the body’s access to air. Other symptoms include excessive sweating (usually locally at the site of skin contamination), excessive tear production, twitching and cramping (progressing to paralysis as muscles fatigue), pupil constriction/dim vision (the iris is a muscle), runny nose, nausea/vomiting/diarrhea, and if it hits the brain, coma and seizures.

The episode specifically mentions runny nose and the cramping til’ you die thing, which is decently accurate. If the cramping progresses to paralysis of your breathing muscles before your airway closes, you can die of cramping.

When people (and by extension the writers of this episode) talk about nerve “gas,” they’re typically referring to the liquid nerve agent being aerosolized (or that certain G-Series agents do tend to evaporate into warm environments even after they settle). Aerosolizing something makes it easier to spread in a crowded area, and is also more immediately life threatening, as breathing the agent causes the more dangerous lung-related symptoms first.

Now, in the episode, Mac stabs himself to release adrenaline. This made sense to me (the adrenaline part, not the stabbing), because given that the VX was aerosolized and he breathed it, Mac was probably suffering bronchoconstriction as an early effect (he coughs several times in the scene). Epinephrine, the pharmaceutical equivalent of (and really just another name for) adrenaline, is a bronchodilator, meaning it relaxes the smooth muscle around the lung passages, allowing more space to draw air.

The presence of extra epi in his system might actually have bought him some time (not sure stabbing himself would have given him enough to accomplish this, but it’s the scientific principle that counts...ish). NOTE: No current treatment protocol actually mentions this or any other bronchodilator, though, so there’s also a chance it’s been shown not to work irl.

Mac leaves the room and immediately leans on Cage and Jack for support, telling them VX takes about 18 hours to kill someone, and that he needs to go to a hospital. This isn’t the case (like, you could suffocate in the first 10 minutes after exposure if you got a high enough dose) but I’m pretty sure I know where they got the number from. 18 hours is the observation window for a dermal exposure- as in, it could take  up to 18 hours to show symptoms if a small dose was absorbed through the skin.

So Jack and Cage might have 18 hours before they start feeling the effects, but Mac definitely needed medical attention ASAP to keep his airway open and save his life. What could accomplish this? Well, there are two commercially available nerve agent exposure kits available- the Mark 1 and the DuoDote. The Mark 1 is an older version, and contains two auto-injectors- one of atropine (a drug that blocks ACH receptors, decreasing symptoms of excess ACH), and pralidoxime (a drug that reactivates the body’s ability to break down ACH). DuoDote has both drugs in one auto-injector.

Atropine is most important for saving the person’s life in the short term, while pralidoxime significantly reduces the overall time the person is ill. It can take weeks for the body to regain the ability to break down ACH on its own, while pralidoxime can permanently reverse the effects of nerve agent poisoning in 1-3 doses. Pralidoxime must be given within a specific window after poisoning in order to be useful- for VX this is a fairly long time, about 60 hours.

I highly doubt Matty would have let her agents go on a mission without an antidote kit each, so I’m guessing they figured out how to use one very quickly in the water treatment center parking lot.

Anyhoo, the day is saved and we get a fairly lengthy scene in either a hospital in New York (which the establishing shot would suggest, unless that’s just an establishing shot of Phoenix we haven’t seen before), or the Phoenix Foundation infirmary (which the set and crack about a loyalty card would suggest), with Mac in a hospital bed.

Finally, I want to point out a nice emotional whump parallel to Classic MacGyver. During a mock interrogation in spy school, Leanna forces Bozer to relive a 911 call he made as a child. His younger brother had gotten ahold of his dad’s loaded handgun and tripped while chasing him around the yard with it. Unfortunately, the gun discharged and Bozer’s brother was killed.

This is a remix of a similar story from the Classic series (recounted during the episode “Blood Brothers”) involving MacGyver and three childhood friends who stole one of their parents’ guns and played with it in the woods. Mac ends up pushing the gun out of his friend’s hand to save a bird he was aiming at, but the gun went off on impact with the ground and injured his other friend Jesse, who later died.

In the Classic series, this event is cited as the reason Mac doesn’t touch guns or let anyone use them around him. I’m interested to see how they’ll use this information in the reboot, given that they’ve established Bozer is willing to use firearms in previous episodes, while Mac, true to his classic counterpart, is not.

[Patreon] [Ko-Fi]

[marketnewzstack-blog]

Global Nerve Gas Auto-Injector Market Research, Revenue Analysis & Growth Trends 2025

Every report Proposed by Market.Biz provides an outlined context of the Industry and the business operators and their effect on industry working. It also projects the key market insights and growth-inducing factors. So, the Recently published Report of Pharmaceuticals and Healthcare category titled as "Global Nerve Gas Auto-Injector Market 2020".

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The day to day market is becoming very much competitive. So, new Entrants and also old players both need a competitive advantage for further growth. The companies competing in the market are truly competing for larger market share and sustainability. this report covers all the competitive strategies used by every small and big business pin down with the help of competitive analysis.

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3) Market Technological Developments fuels the growth of the global market.

4) Developing segment and Region-wise analysis of Nerve Gas Auto-Injector market is provided clear.

Global Competitors competing in the global market: TEVA PHARMACEUTICAL INDUSTRIES LTD., MYLAN TECHNOLOGIES, INC, HIKMA PHARMACEUTICALS PLC., HOSPIRA, MERIDIAN MEDICAL TECHNOLOGIES., SANOFI S.A., BAXTER INTERNATIONAL INC., SOPHARMA AD., SIGMA-ALDRICH CO. LLC.

Global Varieties of the product: Atropin Kit, Atropin Injection, Diazempam Injcetion, Morphine Injection, Pralidoxime Injection

The Global Application of product: Hospital, Residential, Military

The Nerve Gas Auto-Injector Region-based analysis:  India, South America, Europe, Japan, The Middle East & Africa, China and North America

The Pharmaceuticals and Healthcare industry is booming into the technology and strategy based advancements. The main motive of this report is to explore the major players in the industry, evaluating their crucial policies and explaining the Market position globally. This report objectifies to assess the global Nerve Gas Auto-Injector Market depending on factors like SWOT Analysis, Porter’s Five Force Analysis, price analysis, supply chain study and much more.

The Key table of content Nerve Gas Auto-Injector:

1. Market Overview.

2. Global Market Landscape by Competitors.

3. Company Profiles.

4. Global market Production, Revenue (Value), Price Trend by Type,

5. Global Market Analysis by Application.

6. Global Production, Consumption, Export, Import by Region.

7. Market Dynamics.

8. Market Forecast.

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While including detailed information on the emerging prospects of the Nerve Gas Auto-Injector Market, it also manages the insightful forecast assessment of the global market. Various primary and secondary research methods have been used to gather deep insights into the forecast of the Market.

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