چكيده لاتين :
Organophosphorous (OP) chemical warfare nerve agents mainly sarin and tabun were
used during the Iran-Iraq war with high mortalities. In addition to atropine and oximes , the
followings have recently been used successfully for the treatment ofOP poisoning .
1. Sodium Bicarbonate: Infusion of high doses of sodium bicarbonate (5 mEq/kg in 60
min. followed by 5-6 mEq/kg/day to obtain arterial blood pH of7.45 to 7.55) revealed positiv e
effects in pati ents with acute OP poisoning in Mashhad.
2. Magnesium Sulfate: Intravenous magnesium sulfate in a dose of 4 g only on the first day
after admissi on was also effective in acute human OP poison ing.
3. Antioxidants: The toxicity ofOP compounds is mediated by generation ofnitric oxide and
other free radicals. These toxic molecules can be counteracted by antioxidants such as vitamins
C and E, spin traps, melatonin and low molecule weight thiols. The latter compounds can
also increase the synthesis of glutathione, which can both ameliorate the OP-induced oxidative
stress and enhance OP detox ification.
It is concluded Sodium bicarbonate, Magnesium sulfate and the antioxidants should be
added to the standard treatment of OP poisonings.
