Antidotes

The fact that nerve agents have a rapid effect makes it necessary to treat victims immediately. Many countries give armed forces access to auto injectors so that the soldier may easily give himself or another an injection of antidote.

The universally used antidote is atropine. Atropine binds to the acetylcholine (Ach) receptors without causing stimulation. This provides protection against the overabundance of Ach. Essentially, atropine treats the symptoms, but not the cause. For this reason, atropine is commonly used in combination with another class of chemical, called oximes. Oximes treat the cause of the problem by restoring the acetylcholinesterase to an operational form by breaking the enzyme-nerve-agent bond.

Preventative Antidotes

There are also antidotes that can be taken preventatively. Pretreatment is most effective if used with a warning system, because it takes about 30 minutes for the treatments to become effective after ingestion, and their efficacy decreases after 2 hours.

One pretreatment is a carbamate, pyrdostigmine, which inhibits Achase production and protects the enzyme against nerve agents. The inhibition is by about 25% and does not cause any side effects, since the body can function on 5% of the normal levels.

A diazepam tablet can also be given as a pretreatment. Diazepam strengthens the effects of other nerve agent antidotes, increasing survival and decreasing injury.