Epidemology

• Initially synthesized from organophosphate pesticides in the 1950’s

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Exposure

• Wartime Exposure
• Terrorist Acts

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Physiology

• VX Nerve Agent can be distributed as either liquid or aerosol -> toxic via both skin contact and inhalation
• High viscosity (appears viscous, like motor oil) and low volatility -> high persistence in the environment
• Mechanism
  • Cholinergic with Both Muscarinic Agonism and Nicotinic Antagonism

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Clinical

Effects of Muscarinic Agonism

• Bronchorrhea
• Bronchospasm (see Obstructive Lung Disease, [[Obstructive Lung Disease]])

Effects of Nicotinic Antagonism

• Respiratory Muscle Paralysis (see Acute Hypoventilation, [[Acute Hypoventilation]])

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Treatment

• Removal of Liquid Agent from Skin and Evacuation of Victim
• Anti-Cholinergics
  • Atropine: blocks muscarinic Ach receptors
  • Pralidoxime (2-PAM): regenerates bound acetylcholinesterase

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References

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