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The science of chemical nerve agent and organophosphorus insecticide poisoning
Click here to learn more about the physiology of chemical nerve agent and organophosphorus insecticide poisoning and how atropine and pralidoxime chloride treat the effects of poisoning by these compounds.

Chemical nerve agents and organophosphorus insecticides can harm people through contact with the skin or eyes and by ingestion or inhalation. A person's clothing can also absorb and re-release toxic vapors from these compounds for about 30 minutes after contact, which can expose more people to the nerve agent. Because vapors from some nerve agents and insecticides are heavier than air, they can sink to low-lying areas and create a greater exposure hazard there. [22-25]

Within minutes of exposure, people can begin to experience symptoms of chemical nerve agent or insecticide poisoning. Mild symptoms will be observed before severe symptoms. Severe symptoms will appear within 5 minutes after significant inhalation exposure. Death can occur within 5 minutes after the onset of seizures and respiratory arrest. [20]

MILD SYMPTOMS [2, 3]

  • Blurred vision, miosis (excessive constriction of the pupils)
  • Excessive, unexplained teary eyes
  • Excessive, unexplained runny nose
  • Increased salivation, such as sudden drooling
  • Chest tightness or difficulty breathing
  • Tremors throughout the body or muscular twitching
  • Nausea and/or vomiting
  • Unexplained wheezing, coughing, or increased airway secretions
  • Acute onset of stomach cramps
  • Tachycardia or bradycardia (abnormally fast or slow heartbeat)

A quick-reference mnemonic for use in the field is OBSERVE:

Others affected suddenly
Body tremors/twitching
Salivation
Eye tearing
Restricted breathing
Vomiting
Excessive sweating

SEVERE SYMPTOMS [2, 3]

  • Strange or confused behavior
  • Severe difficulty breathing or copious secretions from lungs/airway
  • Severe muscular twitching and general weakness
  • Involuntary urination and defecation
  • Convulsions
  • Loss of consciousness
  • Respiratory arrest (possibly leading to death)

As soon as symptoms of organophosphorus poisoning are identified, treatment should be administered immediately. DuoDote™ Auto-Injectors are indicated for the treatment of poisoning by organophosphorus nerve agents as well as organophosphorus insecticides.

Click here to read more about DuoDote and how it works to counteract the effects of organophosphorus poisoning.

The DuoDote™ Auto-Injector (atropine 2.1 mg/0.7 mL and pralidoxime chloride 600 mg/2 mL) is indicated for the treatment of poisoning by organophosphorus nerve agents as well as organophosphorus insecticides.

IMPORTANT SAFETY INFORMATION

The DuoDote Auto-Injector is intended as an initial treatment of the symptoms of organophosphorus insecticide or nerve agent poisonings; definitive medical care should be sought immediately. The DuoDote Auto-Injector should be administered by Emergency Medical Services personnel who have had adequate training in the recognition and treatment of nerve agent or insecticide intoxication.

Individuals should not rely solely upon agents such as atropine and pralidoxime to provide complete protection from chemical nerve agents and insecticide poisoning. Primary protection against exposure to chemical nerve agents and insecticide poisoning is the wearing of protective garments including masks designed specifically for this use. Evacuation and decontamination procedures should be undertaken as soon as possible. Medical Personnel assisting evacuated victims of nerve agent poisoning should avoid contaminating themselves by exposure to the victim's clothing.

In the presence of life-threatening poisoning by organophosphorus nerve agents or insecticides, there are no absolute contraindications to the use of the DuoDote Auto-Injector. When symptoms of poisoning are not severe, DuoDote Auto-Injector should be used with extreme caution in people with heart disease, arrhythmias, recent myocardial infarction, severe narrow angle glaucoma, pyloric stenosis, prostatic hypertrophy, significant renal insufficiency, chronic pulmonary disease, or hypersensitivity to any component of the product.

Please click here to view full prescribing information for DuoDote.

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