Eisenkraft Arik, Gilat Eran, Chapman Shira, Baranes Shlomo, Egoz Inbal, Levy Aharon
CBRN Medical Branch, Medical Corps, Israel Defense Force, Israel.
Biopharm Drug Dispos. 2007 Apr;28(3):145-50. doi: 10.1002/bdd.541.
Immediate administration of antidotal treatment is crucial in severe organophosphate (OP) poisoning and the use of an open intravenous (i.v.) line might also be required. The state of casualties might prevent getting access to their veins. The bone injection gun (BIG) was established as a simple method for introducing an intraosseous (i.o.) line and could be applied while wearing a protective suit. The present study followed the pharmacokinetics of the anticonvulsive drug midazolam after i.o. administration in pigs compared with i.v. and the common intramuscular (i.m.) administration. A new method for monitoring midazolam concentrations in plasma was developed. Plasma concentrations following both i.v. and i.o. administrations peaked at 2 min post injection and only at 10 min following the i.m. route. In an antidotal treatment study against paraoxone poisoning, the anticonvulsive effect of midazolam appeared immediately following i.o. administration, while it took 5-10 min to exhibit a similar effect following i.m. administration. This study indicates that the use of i.o. administration after OP poisoning might provide the necessary fast response for rapid termination of convulsions. The BIG might offer a convenient method for treating casualties in the chemical arena by teams wearing full protective gear.
在严重有机磷（OP）中毒时立即给予解毒治疗至关重要，可能还需要使用开放静脉（i.v.）通路。伤亡者的状况可能会妨碍静脉穿刺。骨注射枪（BIG）作为一种建立骨内（i.o.）通路的简单方法被确立，并且可以在穿着防护服时使用。本研究追踪了抗惊厥药物咪达唑仑在猪体内骨内给药后的药代动力学，并与静脉给药和常见的肌肉内（i.m.）给药进行比较。开发了一种监测血浆中咪达唑仑浓度的新方法。静脉给药和骨内给药后血浆浓度在注射后2分钟达到峰值，而肌肉内给药后在10分钟才达到峰值。在一项针对对氧磷中毒的解毒治疗研究中，咪达唑仑的抗惊厥作用在骨内给药后立即出现，而肌肉内给药后需要5 - 10分钟才表现出类似效果。本研究表明，有机磷中毒后使用骨内给药可能为迅速终止惊厥提供必要的快速反应。骨注射枪可能为穿着全套防护装备的团队在化学环境中治疗伤亡者提供一种便捷方法。
