TY - JOUR
AU1 - GROB, DAVID
AB - Abstract THE NERVE gases are a group of highly toxic organic esters of phosphoric acid derivatives which have physiologic effects attributable to the inhibition of cholinesterase enzymes. The effects resemble those produced by physostigmine and neostigmine (Prostigmin) but are more intense and more prolonged. The nerve gases are among the most toxic of the chemical warfare agents, and they are the most adaptable to long-range attack, as upon civilian populations.1 A number of related but somewhat less toxic organic phosphate anticholinesterase compounds have proved to be useful in medicine and in agriculture. Diisoprophyl fluorophosphate (DFP) has been studied in detail* and has been employed as a therapeutic agent in the management of abdominal distention,† urinary retention, and glaucoma.6 Tetraethylpyrophosphate (TEPP) 7 and octamethyl pyrophosphoramide (OMPA) 8 proved to be of some value in the management of myasthenia gravis, but they have been replaced by less potent anticholinesterase compounds. Parathion, bis-(monoisopropylamino)-fluorophosphine References 1. References 2-5. 2. References 2-5. 3. References 9-11. 4. The structural formula of sarin, which has also been designated GB, is 5. References 12-13. 6. References 14-17. 7. References 14-17. 8. References 2-5. 9. References 2-5. 10. References 21 and 22. 11. Wood, J. R.: Chemical Defense , J.A.M.A. 145:1264-1267, 1951.Crossref 12. Grob, D.; Lilienthal, J. L.; Harvey, A. M., and Jones, B. F.: The Administration of Di-Isopropyl Fluorophosphate (DFP) to Man: I. Effect on Plasma and Erythrocyte Cholinesterase; General Systemic Effects; Use in Study of Hepatic Function and Erythropoiesis, and Some Properties of Plasma Cholinesterase , Bull. Johns Hopkins Hosp. 81:217-244, 1947. 13. Grob, D.; Lilienthal, J. L., Jr., and Harvey, A. M.: The Administration of Di-Isopropyl Fluorophosphate (DFP) to Man: II. Effect on Intestinal Motility and Use in the Treatment of Abdominal Distention , Bull. Johns Hopkins Hosp. 81:245-256, 1947. 14. Grob, D.; Harvey, A. M.; Langworthy, O. R., and Lilienthal, J. L., Jr.: The Administration of Di-Isopropyl Fluorophosphate (DFP) to Man: III. Effect on the Central Nervous System with Special Reference to the Electrical Activity of the Brain , Bull. Johns Hopkins Hosp. 81:257-266, 1947. 15. Harvey, A. M.; Lilienthal, J. L. Jr.; Grob, D.; Jones, B. F., and Talbot, S. A.: The Administration of Di-Isopropyl Fluorophosphate to Man: IV. The Effects on Neuromuscular Function in Normal Subjects and in Myasthenia Gravis , Bull. Johns Hopkins Hosp. 81:267-292, 1947. 16. Leopold, I. H., and Comroe, J. H., Jr.: Use of Di-Isopropyl Fluorophosphate ("DFP") in Treatment of Glaucoma , Arch. Ophth. 36: 1-16, 1946.Crossref 17. Grob, D.; Garlick, W. L., and Harvey, A. M.: The Toxic Effects in Man of the Anticholinesterase Insecticide Parathion (p-Nitrophenyl Diethyl Thionophosphate) , Bull. Johns Hopkins Hosp. 87:106-129, 1950. 18. Rider, J. A.; Schulman, S.; Richter, R. B.; Moeller, H. C., and DuBois, K. P.: Treatment of Myasthenia Gravis with Octamethyl Pyrophosphoramide: Preliminary Report , J.A.M.A. 145:967-972, 1951.Crossref 19. Grob, D., and Harvey, A. M.: Observations on the Effects of Tetraethyl Pyrophosphate (TEPP) on Man and on Its Use in the Treatment of Myasthenia Gravis , Bull. Johns Hopkins Hosp. 84:532-567, 1949. 20. Pharmacology and Toxicology of Certain Organic Phosphorus Insecticides, Report to the Council on Pharmacy and Chemistry of the American Medical Association , J. A. M. A. 144:104-108, 1950.Crossref 21. Grob, D.: Uses and Hazards of the Organic Phosphate Anticholinesterase Compounds , Ann. Int. Med. 32:1229-1234, 1950.Crossref 22. Krop, S., and Kunkel, A. M.: Observations on Pharmacology of the Anticholinesterases Sarin and Tabun , Proc. Exper. Biol. & Med. 86:530-533, 1954. 23. Holmstedt, B.: Synthesis and Pharmacology of Tabun, Together with a Description of Some Allied Organic Phosphate Anticholinesterase Compounds Containing the N-P Bond , Acta physiol. scandinav. ( (Supp. 90) ) 25:1-120, 1951. 24. Grob, D.; Harvey, J. C., and Harvey, A. M.: Observations on the Effects in Man of Methyl Isopropyl Fluorophosphonite (Sarin), Medical Division (Chemical Corps) Research Report, No. 18, September, 1950. 25. Grob, D., and Harvey, A. M.: The Effects and Treatment of Nerve Gas Poisoning , Am. J. Med. 14:52-63, 1953. 26. Grob, D.: Further Observations on the Effects in Man of Methyl Isopropyl Fluorophosphonite (Sarin): Effects of Percutaneous Absorption Through Intact and Abraded Skin , Medical Laboratories (Chemical Corps) Contract Report, No. 14, Army Chemical Center, Md., January, 1953. 27. Grob, D.; Johns, R. J., and McKusick, V. A.: Treatment of Human Exposure to Anticholinesterases , Medical Laboratories (Chemical Corps) Contract Report, No. 60, Army Chemical Center, Md., July, 1955. 28. Michel, H. O.: An Electrometric Method for the Determination of Red Blood Cell and Plasma Cholinesterase Activity , J. Lab. & Clin. Med. 34:1564-1568, 1949. 29. Kondritzer, A.: Decontamination of Nerve Gas , Armed Forces M. J. , to be published. 30. Grob, D.: Manifestations and Treatment of Nerve Gas Poisoning in Man , Armed Forces M. J. , to be published. 31. Elam, J. O.; Clements, J. A.; Brown, E. S., and Elton, N. W.: Artificial Respiration for the Nerve Gas Casualty , Armed Forces M. J. , to be published. 32. Elam, J. O.; Brown, E. S., and Elder, J. D., Jr.: Artificial Respiration by Mouth to Mask Methods: A Study of the Respiratory Gas Exchange of Paralyzed Patients Ventilated by Operator's Expired Air , New England J. Med. 250:749-754, 1954. 33. Bidstrup, P. L.; Bonnell, J. A., and Beckett, A. G.: Paralysis Following Poisoning by a New Organic Phosphorus Insecticide (Mipafox) , Brit. M. J. 1:1068, 1953. 34. 853 S. 12th St. (8).
TI - THE MANIFESTATIONS AND TREATMENT OF POISONING DUE TO NERVE GAS AND OTHER ORGANIC PHOSPHATE ANTICHOLINESTERASE COMPOUNDS
JF - A.M.A. Archives of Internal Medicine
DO - 10.1001/archinte.1956.00250260095010
DA - 1956-08-01
UR - https://www.deepdyve.com/lp/american-medical-association/the-manifestations-and-treatment-of-poisoning-due-to-nerve-gas-and-1pH4SHp0w0
SP - 221
EP - 239
VL - 98
IS - 2
DP - DeepDyve
ER -