Deep Dive MW R12

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