Cholinesterase Reactivators as Prophylactics Against Nerve Agents

Jiri      Bajgar; Kamil      Kuca; Josef      Fusek; Daniel      Jun; Lucie      Bartosova

Abstract

Prophylaxis against nerve agent intoxication is based on various approaches: Keeping AChE, key enzyme for toxic action of OP/nerve agents intact (protection of cholinesterases) is a basic requirement for effective prophylaxis. Detoxification realised by administration of the enzymes splitting the OP or evaluating specific enzymes (cholinesterases) is another possibility (scavenger effect). The antidotes currently used for the treatment of OP poisoning including reactivators are to be tested as prophylactics. This principle can be considered as a “treatment in advance”. Moreover, they are uneffective when administered alone; their effect is potentiated when they are administered with anticholinergics. Transdermal administration of reactivator HI-6 was used and prophylactic antidote TRANSANT was developed and introduced into the Czech Army. At present, PYRIDOSTIGMINE seems to be common prophylactic antidote; prophylactics PANPAL (tablets with pyridostigmine, trihexyphenidyle and benactyzine), TRANSANT (transdermal patch containing HI-6) are other means introduced into different armies as prophylactics. TRANSANT is only one prophylactics evaluating reactivator. When administered simultaneously with PANPAL, prophylactic efficacy is increased and represents the best prophylaxis at present.

Keywords: Prophylaxis, principles, nerve agents, cholinesterase reactivators, present prophylactic means