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Nerve Agent Exposure > Diagnosis Author: Elliot Rodriguez, MD, FACEP; Christine M. Stork, PharmD, DABAT
Editorial changes - 2009-12-01
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Rationale:

  • Systemic symptoms may lag for up to 18 hours after dermal exposure due to the need for absorption to occur, whereas local effects on the mucous membranes occur quickly after exposure to vaporized nerve agents.

Evidence:

  • Multiple case series and reference texts note that miosis is an early and sensitive sign of nerve agent toxicity after vapor exposure (6; 13; 16; 17).
  • A case report of VX poisoning and case series of experimental VX dermal exposures show a delay in onset of miosis and other systemic symptoms (11; 17).

Comments:

  • None.

FAQs
Christine M. Stork, PharmD, DABAT has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Elliot Rodriguez, MD, FACEP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Jerrold B. Leikin, MD, editorial consultant, received royalties from McGraw-Hill, Taylor and Francis; editor of Toxicoterrorism (McGraw-Hill).
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given.


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