| dc.description.abstract | The potential for exposure to chemical warfare nerve agents exists on the battlefield and as a terrorist threat to civilians.
Nerve agents are irreversible inhibitors of the acetylcholinesterase enzyme and there-by induce hyperactivity of the
cholinergic systems in the brain and in the periphery. Exposure causes a progression of toxic signs, including hypersecretions,
fasciculations, tremor, convulsions, respiratory distress and death. A combined regimen consisting of prophylaxis
and medical therapy is considered the most effective medical countermeasure for management of nerve agent
poisoning of military personnel. In case of terrorist use of nerve agents against civilians, only post-exposure treatment is
feasible. The use of prophylaxis and medical treatment or only medical treatment after exposure does not prevent the
development of nerve agent-induced brain seizures. Prolonged epileptic seizures in a nerve agent casualty will produce
profound, irreversible, brain damage that in turn will result in long-term deficits in cognitive function and behaviour. It
is considered important to co-administer a GABAergic agonist, such as diazepam, with the currently used regime of
carbamate prophylaxis and follow-up medical treatment with atropine and oxime. Experimental studies in NATO have
shown that diazepam does not provide total protection against nerve agent induced brain injuries. An active research is,
therefore, necessary to find better and more effective drugs. Several drugs have been studied and some drugs have
shown to provide a better anticonvulsant effects than others. Future research will probably identify drugs that will be
more efficient in protecting humans from injuries following exposure to nerve agents than the present ones in use. | en_GB |