Nerve Agents
Nerve agents
- Advice on management of poisonings as always is from the National Poisons Information Service
- In nerve agent poisoning it is important that pralidoxime mesylate (P2S) be given as early as possible, and within two hours of exposure if at all possible.
- Substantial quantities of P2S are likely to be required by EDs receiving casualties
- The antidote for nerve agents (organophosphates, sarin and other agents) are pralidoxime mesylate (P2S), atropine and saline
- More detailed indications and therapeutic effects of Pralidoxine in such cases is available from Toxbase website or the National Poisons Information Service
- UK DoH patient group directions on the use of Pralidoxime and Obidoxime
- If the nerve agent is thought or known to be Tabun (GA) then Obidoxime should be requested. Obidoxime can also be ordered separately for patients who have not responded adequately to supportive measures, pralidoxime mesylate and atropine
- The antidote to cyanide poisoning is Dicobolt Edetate
- Botulinum antitoxin is also held by the National Blood Service
UK DoH publication on dosage administration P2S.
Cyanide
- The antidote to cyanide poisoning (Dicobolt Edetate) is also called for as a "pod" by contacting the ambulance (if they have not already asked for it to be sent to the hospital when attending the scene).
- These antidote pods are stocked by the blood service but ordered through the hospital pharmacy
Botulinum antitoxin
- Botulinum antitoxin is also held by the National Blood Service
Links
- Public Health Laboratory Service
- NeLH anhrax page
- Algorithm for possible exposure to Ricin / other toxic substance here
- Patient group directions for Atropine, Pralidoxime, Obidoxime, Dicobalt edetate, Ciprofloxacin, Doxycycline
