CR

CR Dibenzoxazepine
CR - A New Irritant Agent
CR
Dibenzoxazepine

| Color
Code: |
Violet |
| Agent
State: |
Micro-Particulate Solid |
| Classification: |
Irritant |
CR is a potent sensory irritant. CR is the parent
compound of Loxapine Succinate, an Anti-Psychotic drug. CR is usually disseminated in a
liquid solution with a propylene glycol base.
CRs physical properties are similar to those of CS, but
CRs effects on the individual are more severe. In addition to affecting the eyes and
respiratory tract, CR induces intense skin pain.
CR causes eye pain and excessive tearing. Slight edema to the eye
lids may last for 2 to 6 hours. Skin pain and reddening are CRs two main effects.
Although burning sensation may last for 15 to 30 minutes, the reddening may persist for
several hours. Areas of the skin previously exposed to CR may become painful again when
exposed to water even after 24 hours or longer. CR, when entering the mouth, causes a
burning sensation, excessive salivation, sore throat, and a mucous discharge from the
nose.
Health Hazards of CR
CR appears to have a greater safety ratio than either CN or CS.
However, CR is a relatively toxic agent and the mortal dose in a human subject is of the
same order of magnitude as the other war gases. In a poorly ventilated environment an
individual can inhale a fatal dose within minutes. Death results from asphyxiation
associated with the development of pulmonary edema.
CR medical treatment is largely palliative (to lessen the severity
without cure), and induces reassurance, removal of contaminated clothing, and washing of
eyes and skin. Eye pain can be relieved with medications.
Due to CRs persistent and long-term effect, presently very few
liability conscious agencies use this agent.
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CR
A New Irritant Agent

The New England Journal of Medicine
Vol. 299 No. 16 (October 5, 1978)
JACK I. PINKOS, Ph.D.
"CR - A NEW IRRITANT AGENT"
The medical community has been educated about the nature of the active agents involved
(i.e., alpha-chloroacetophenone [CN] and ortho-chlorobenzalmalononitrile {CS]) and the
need for prompt decontamination to minimize cutaneous trauma and the possibility of
sensitization. Physicians should now be aware that a third irritant agent is available as an
alternative to CN and CS. This agent, dibenz[b,fl [1,41oxazepine (CR), is a potent sensory
irritant. Patients should be informed that areas of the skin previously exposed to CR may
become painful again when exposed to water even after 24 hours or longer.
The structure of CR is that of two benzene rings doubly linked to one another via an
ether linkage and an azomethine function (-CH=N-), thus affording a central 7-membered
ring. CR can be considered to be a derivative of salicylaldehyde. Also, the relation of CR
to the antipsychotic agent loxapine succinate. (Loxitane) has not previously been noted.
Loxapine succinate is the succinic acid salt of
2-chloro-11-(4-methyl-1-piperazinyl)dibenz[b,f] [1,4]oxazepine. CR is the parent compound
of loxapine. Replacement of the azomethine hydrogen with the heterocyclic ring and
replacement of an aryl hydrogen with chlorine furnishes loxapine. Another common bond also
exists between the irritant agents and loxapine; they all effect a rapid and marked
decline in aggressive behavior.
Further Readings
- Holland P: The cutaneous reactions produced by dibenzoxazepine (CR). Br J Dermatol
90:657-659, 1974
- Ballantyne B. Beswick FW, Price Thomas D: The presentation and management of individuals
contaminated with solutions of dibenzoxazepine (CR). Med Sci Law 13:265-268, 1973
- Kramer M, Roth T. Salis PJ, et al: Relative efficacy and safety of loxapine succinate
(Loxitane.) and thioridazine hydrochloride (Mellaril.) in the treatment of acute
schizophrenia. Curr Ther Res 23:619-631, 1978
- Bishop MP, Gallant DM: Loxapine: a controlled evaluation in chronic schizophrenic
patients. Curr Ther Res 12:594-597, 1970
- Paprocki J. Versiani M: A double-blind comparison between loxapine and haloperidol by
parenteral route in acute schizophrenia. Curr Ther Res 21:80-100, 1977