Treatment and antidotes for chemical weapons exposure

Treatment and antidotes for chemical weapons exposure

Listed here are potentially threatening chemical agents, treatments currently available, and antidotes.

In the event of chemical agent exposure, follow standard precautions and decontamination protocols, such as removing clothing and sealing it in plastic bags, irrigating the eyes, washing skin and hair using copious water, treating waste water as needed, and decontaminating the health care facility according to the specific agent involved.

Chemical agent	Treatment	Antidote
Nerve agents Sarin Soman Tabun VX	Supportive care Diazepam or lorazepam to prevent seizures	Atropine I.M. or I.V. Pralidoxime chloride I.M. or I.V.
Cyanides Cyanogen chloride Hydrogen cyanide	Supportive care 100% oxygen by face mask; may need en-dotracheal (ET) intubation with 100% FIO 2 Activated charcoal for conscious patient	Amyl nitrite via inhalation Sodium nitrite I.V. and sodium thiosulfate I.V.; dosage based on patient’s weight and hemoglobin level
Vesicants or blister agents Lewisite Mustard lewisite Nitrogen mustard Phosgene oxime Sulfur mustard	Thermal burn therapy Respiratory support and eye care	No antidote available for mus-tards or phosgene oxime For lewisite and lewisite mustard mixtures: British Anti-Lewisite I.M. (rarely available)
Pulmonary or choking agents Chlorine Diphosgene Phosgene Sulfur dioxide	Supportive care Oxygen thera-py; possible ET intubation and mechanical ventilation with positive-end expiratory pressure	None
Ricin (biotoxin isolated from castor bean oil extract)	Supportive care For ingestion, activated charcoal	None
T-2 mycotoxins (toxic compounds pro-duced by fungi) Fusarium Myrotecium Stachybotrys Trichoderma Verticimonosporium	«Supportive
Supportive care For ingestion, activated charcoal Possible high-dose steroids	None