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How likely is it that a terrorist group would use chemical nerve agents against the general population? Is it possible that any of the chemical nerve agents currently being kept in military storage facilities could be accidentally released into the environment? Could a manufacturing or transportation accident involving organophosphorus insecticides put a large number of people at risk? These important questions are addressed in this section on threat assessment.

Terrorism Using Chemical Weapons
Since a 1995 incident involving the release of sarin (GB) nerve gas in the Tokyo subway by a religiously motivated cult known as Aum Shinrikyo, [9] national security and public health officials have carefully assessed the risk of large-scale use of chemical weapons against the general population. Documentation suggests that terrorist groups, including al-Qaeda, continue to show an active interest in obtaining and using chemical weapons, including nerve agents. [10] Please click here to read a synopsis of the Tokyo attack and learn more about the potential for future uses of chemical nerve agents by terrorists.

Large-Scale Accidental Exposure to Insecticides
Organophosphorus insecticides represent, by weight, nearly 70% of all pesticides used in the United States. [5] With such extensive use, there is always the potential for injury and even death due to accidental poisoning—whether during the manufacture, transport, or application of these chemicals. Please click here to learn more about the risks of organophosphorus insecticide 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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DuoDote Auto-Injector, the DuoDote Logo, Mark I Kit, and BinaJect are trademarks of Meridian Medical Technologies™, Inc., a wholly owned subsidiary of King Pharmaceuticals®, Inc. Copyright ® 2010 Meridian Medical Technologies™, Inc., a wholly owned subsidiary of King Pharmaceuticals®, Inc. All rights reserved. MMT6193 06/2009