Chai Peter R, Hayes Bryan D, Erickson Timothy B, Boyer Edward W
Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A.
The Fenway Institute, Boston, MA, U.S.A.
Toxicol Commun. 2018;2(1):45-48. doi: 10.1080/24734306.2018.1475151. Epub 2018 Jun 29.
The , or "newcomer" class of nerve agents are lesser characterized, weaponized organophosphate agents. The use of known agents in warfare is banned under the Chemical Weapons Convention of 1997. agents are considered more potent than VX gas and can be applied in unitary and binary forms. Like other nerve agents, agents irreversibly bind acetylcholinesterase and produce a cholinergic toxidrome. Uniquely, these agents are thought to also target neurons in the peripheral nervous system. Delayed treatment or massive exposure may therefore cause a debilitating neuropathy. The recent 2018 assassination attempt of Russian dissident Sergei Skripal and his daughter Yulia in the United Kingdom highlights the importance of recognizing the potential lethal effects of these nerve agents. Treatment of agent poisoning is similar to management of other nerve agents. Given increasing worldwide incidents attributed to chemical weapons such as agents, clinicians should know how to rapidly recognize symptoms of acute poisoning and administer life-saving antidotal therapy, when indicated.
关于“新型”神经毒剂，即特征了解较少的、已武器化的有机磷酸酯类毒剂。1997年《化学武器公约》禁止在战争中使用已知的此类毒剂。此类毒剂被认为比VX毒气更具毒性，可制成单一型和二元型。与其他神经毒剂一样，此类毒剂会不可逆地结合乙酰胆碱酯酶并产生胆碱能中毒综合征。独特的是，这些毒剂还被认为会作用于周围神经系统的神经元。因此，延迟治疗或大量接触可能会导致使人衰弱的神经病变。2018年在英国发生的针对俄罗斯持不同政见者谢尔盖·斯克里帕尔及其女儿尤利娅的暗杀未遂事件凸显了认识到这些神经毒剂潜在致命影响的重要性。此类毒剂中毒的治疗与其他神经毒剂的处理方法类似。鉴于全球范围内归因于化学武器（如此类毒剂）的事件不断增加，临床医生应知道如何在有指征时迅速识别急性中毒症状并给予挽救生命的解毒治疗。
