The Role of Diazepam in the Treatment of Nerve Agent Poisoning in a Civilian Population

@article{Marrs2004TheRO,
  title={The Role of Diazepam in the Treatment of Nerve Agent Poisoning in a Civilian Population},
  author={Timothy Clive Marrs},
  journal={Toxicological Reviews},
  year={2004},
  volume={23},
  pages={145-157}
}
  • T. Marrs
  • Published 2004
  • Medicine, Biology, Psychology
  • Toxicological Reviews
The main site of action of diazepam, as with other benzodiazepines, is at the GABAA receptor, although it has been suggested that some of the potentially beneficial actions of diazepam in nerve agent poisoning are mediated through other means. It is likely that convulsions may have long-term sequelae in the central nervous system, because of damage by anoxia and/or excitotoxicity. Numerous pharmacodynamic studies of the action of diazepam in animals experimentally poisoned with nerve agents… 
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References

SHOWING 1-10 OF 91 REFERENCES
Diazepam in the Treatment of Organophosphorus Ester Pesticide Poisoning
  • T. Marrs
  • Medicine, Psychology
    Toxicological reviews
  • 2003
TLDR
Diazepam should be given intravenously to patients treated in hospital for OP poisoning whenever convulsions or pronounced muscle fasciculation are present, and in severe poisoning, diazepam administration should be considered even before these complications develop.
Review of the value of gacyclidine (GK-11) as adjuvant medication to conventional treatments of organophosphate poisoning: primate experiments mimicking various scenarios of military or terrorist attack by soman.
Today, organophosphorus nerve agents are still considered as potential threats in both military or terrorism situations. These agents act as potent irreversible inhibitors of acetylcholinesterase in
Efficacy of biperiden and atropine as anticonvulsant treatment for organophosphorus nerve agent intoxication
TLDR
It is demonstrated that all nerve agents can produce status epilepticus and that the therapeutic effectiveness of atropine and biperiden roughly paralleled the seizurogenic potential of these agents.
Evaluation of Anticonvulsant Drugs for Soman-Induced Seizure Activity
TLDR
Screening studies in rats showed that the clinically effective antiepileptic drugs pentobarbital and valproic acid were modestly effective in terminating seizures when given shortly (5 min) after seizure onset, and some antimuscarinic compounds lost anticonvulsant efficacy when treatment was delayed 40 min.
Anticonvulsants for soman-induced seizure activity.
This report describes studies of anticonvulsants for the organophosphorus (OP) nerve agent soman: a basic research effort to understand how different pharmacological classes of compounds influence
...
...