Boyer EW

References (4)

Title : Novichok agents: a historical, current, and toxicological perspective - Chai_2018_Toxicol.Commun_2_45
Author(s) : Chai PR , Hayes BD , Erickson TB , Boyer EW
Ref : Toxicol Commun , 2 :45 , 2018
Abstract : The Novichok, or "newcomer" class of nerve agents are lesser characterized, weaponized organophosphate agents. The use of known Novichok agents in warfare is banned under the Chemical Weapons Convention of 1997. Novichok agents are considered more potent than VX gas and can be applied in unitary and binary forms. Like other nerve agents, Novichok 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 Novichok agent poisoning is similar to management of other nerve agents. Given increasing worldwide incidents attributed to chemical weapons such as Novichok agents, clinicians should know how to rapidly recognize symptoms of acute poisoning and administer life-saving antidotal therapy, when indicated.
ESTHER : Chai_2018_Toxicol.Commun_2_45
PubMedSearch : Chai_2018_Toxicol.Commun_2_45
PubMedID: 30003185

Title : Toxic chemical weapons of assassination and warfare: nerve agents VX and sarin - Chai_2017_Toxicol.Commun_1_21
Author(s) : Chai PR , Boyer EW , Al-Nahhas H , Erickson TB
Ref : Toxicol Commun , 1 :21 , 2017
Abstract : The use of VX and sarin as weapons of assassination and warfare raises important considerations for healthcare professionals who may encounter victims, bystanders, and responders who require prompt assessment and treatment. Chemical warfare agents such as VX and sarin constitute a considerable threat to the health of the civilian population, military personnel, and peacekeeping forces. Healthcare providers should recognize symptoms of nerve agent exposure, understand regional and international notification procedures for potential attacks, as well as the indications for and available supply of antidotal therapy.
ESTHER : Chai_2017_Toxicol.Commun_1_21
PubMedSearch : Chai_2017_Toxicol.Commun_1_21
PubMedID: 29974075

Title : Diazepam inhibits organophosphate-induced central respiratory depression - Dickson_2003_Acad.Emerg.Med_10_1303
Author(s) : Dickson EW , Bird SB , Gaspari RJ , Boyer EW , Ferris CF
Ref : Acad Emerg Med , 10 :1303 , 2003
Abstract : OBJECTIVES: Current evidence suggests that mortality from acute organophosphate (OP) poisoning is partially mediated through central nervous system (CNS) respiratory center depression (CRD). However, the exact mechanism of OP-induced CRD is unknown. In these studies, the authors investigated the hypothesis that OP-induced CRD is the result of overstimulation of CNS respiratory centers.
METHODS: Wistar rats received prophylaxis with either normal saline (controls), atropine, the peripherally acting anticholinergics glycopyrrolate (GLYC), ipratropium bromide (IB), or the CNS respiratory center attenuator diazepam. To determine if a dual CNS/peripheral cholinergic mechanism is responsible for animal death, two additional groups received combination treatment with diazepam plus either IB or GLYC. All treatments were completed 5 minutes before OP with subcutaneous dichlorvos. Differences in 10-minute and 24-hour mortality were assessed by the Fisher exact test.
RESULTS: Dichlorvos poisoning resulted in profound fasciculations without obvious seizure in all cohorts. In controls and animals treated with peripherally acting anticholinergics, fasciculations were followed by sedation and respiratory arrest (0% 10-minute survival in all cohorts). In contrast, pretreatment with either atropine or diazepam significantly improved 10-minute survival (100% and 44%, respectively). Although GLYC or IB afforded no protection when given alone, when delivered in conjunction with diazepam, the combination significantly improved survival (both groups 88% at 24 hours), suggesting a dual CNS/pulmonary muscarinic mechanism of lethality.
CONCLUSIONS: The central respiratory depressant diazepam paradoxically attenuates organophosphate-induced respiratory depression, and when combined with peripherally acting anticholinergic agents, reduces mortality in a rat model of severe acute OP poisoning.
ESTHER : Dickson_2003_Acad.Emerg.Med_10_1303
PubMedSearch : Dickson_2003_Acad.Emerg.Med_10_1303
PubMedID: 14644779

Title : Use of physostigmine in the management of gamma-hydroxybutyrate overdose -
Author(s) : Boyer EW , Quang L , Woolf A , Shannon M
Ref : Annals of Emergency Medicine , 38 :346\; author reply 347 , 2001
PubMedID: 11524662