Development of Optimized Guidelines for Therapeutic Strategies for Organophosphate Poisoning
AIR FORCE INST OF TECH WRIGHT-PATTERSON AFB OH GRADUATE SCHOOL OF ENGINEERING AND MANAGEMENT
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Organophosphates such as nerve agents have been used on several occasions in the past to inflict harm upon military and civilian populations in various parts of the world. The threat of these chemicals use against the military and civilians continues today, and the suggested treatment guidelines available may be ineffective or possibly cause harm. The guidelines investigated during the research presented here all included the use of two antidotes, atropine and oxime. The efficacy of oximes has been questioned and it has been suggested that they may cause harm to the patient. Both atropine and oxime are issued to military members for self-treatment following nerve agent exposure. Additionally, civilian medical facilities have access to both antidotes to treat patients exposed to nerve agents or organophosphate-based pesticides. The research presented here used a physiologically-based pharmacokinetic model to determine an optimal treatment strategy for exposures to organophosphates. Results from the model suggest that the treatment of organophosphate poisoning according to current guidance has the potential to increase the severity of symptoms that a patient is experiencing. The results presented indicate that oxime use is beneficial when the patient has been exposed to a weak organophosphate such as a pesticide, but not as prescribed in current guidance. Additionally, results indicate that in scenarios involving strong organophosphates such as nerve agents, oxime use is ineffective and has the potential to increase the severity of symptoms. Finally, the model was used to determine an optimal dosing strategy for treatment of organophosphate poisoning that varies significantly from the guidance currently available.
- Medicine and Medical Research
- Organic Chemistry