Chemical Weapons Poisoning

Chemical Weapons Poisoning is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

Chemical agents that affect CNS, pulmonary, cardiovascular, dermal, ocular, or GI systems when exposed to victims

Etiology

  • Blood agents: Cyanide:
    • Inhibition of cellular respiration by binding to ferric ion in cytochrome oxidase a-a3 and uncoupling oxidative phosphorylation
  • Blister agents: Sulfur mustard, nitrogen mustard, lewisite, phosgene oxime:
    • Alkylation and cross-linking of purine bases of DNA and amino acids resulting in change in structure of nucleic acid, proteins, and cellular membranes
  • Lacrimators and riot control agents: 1-chloroacetophenone (CN; Mace), o-chlorobenzylidene malononitrile (CS), oleoresin capsaicin-pepper spray (OC), chloropicrin, adamsite (DM):
    • Mucous membrane irritators
  • Pulmonary irritants (choking agents):
    • High water solubility: Ammonia:
      • Mucous membrane irritation of eyes and upper airway
    • Intermediate water solubility: Chlorine:
      • Forms hydrochloric acid, hydrochlorous acids, which form free radicals causing upper airway and pulmonary irritation
    • Low water solubility: Phosgene:
      • Mild irritant effects initially, then delayed pulmonary edema as late as 24 hr
      • Direct pulmonary damage after hydrolysis in lungs to hydrochloric acid
  • Nerve agents:
    • Anticholinesterase inhibitors—causes cholinergic overstimulation at muscarinic, nicotinic, and CNS sites
  • Incapacitating agents: 3-quinuclidinyl benzilate (BZ):
    • Anticholinergic (antimuscarinic)

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Citation

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TY - ELEC T1 - Chemical Weapons Poisoning ID - 307180 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307180/all/Chemical_Weapons_Poisoning ER -