APPLICATIONS USED IN TREATMENT AGAINST CHEMICAL WEAPONS AND BIOTERRORISM

Yıl 2024, Cilt: 48 Sayı: 2, 672 - 695, 20.05.2024

Sibel İlbasmış Tamer , İlkay Erdoğan Orhan

https://doi.org/10.33483/jfpau.1363452

Öz

Objective: In the present study, the chemical and physical properties of various chemical warfare agents, general information about medical protection methods, current analysis methods equipment, decontamination techniques and pharmaceutical formulations used when exposed to chemical agents will be discussed.
Result and Discussion: Among weapons of mass destruction, chemical warfare agents are one of the most brutal dangers posed to humanity compared to biological and nuclear weapons. These war agents can be produced easily, cheaply and can cause mass casualties in small amounts with chemicals that are easily obtained in our daily lives, even by small terrorist groups. Chemical warfare agents can enter the body through various routes; and symptoms may vary accordingly. When inhaled, gases, vapors and aerosols can be absorbed through any part of the respiratory tract, from the mucosa of the nose and mouth to the alveoli of the lungs. The eye may able to absorb these agents directly. Liquid droplets and solid particles can be absorbed from the surface of the skin and mucous membranes. Toxic compounds that have a characteristic effect on the skin can demonstrate their effects when they accumulate on the skin as solid or liquid particles. The vapors of some volatile substances can penetrate intact skin and subsequently cause poisoning. Wounds or abrasions are more permeable than intact skin. Chemical warfare agents can contaminate food and beverages and absorbed into the gastrointestinal tract. While chemical warfare agents penetrate through various transmucosal routes, they can cause irritation or damage to the surfaces. In addition, toxic substances can pollute groundwater, leaking into the environment by soil and air and cause long-term harmful effects on living organisms.

Anahtar Kelimeler

Bioterrorism, chemical warfare agents, decontamination, drug therapy

KİMYASAL SİLAHLARA VE BİYOTERÖRE KARŞI TEDAVİDE KULLANILAN UYGULAMALAR

Öz

Amaç: Bu çalışmada çeşitli kimyasal savaş ajanlarının kimyasal ve fiziksel özellikleri, tıbbi koruma yöntemleriyle ilgili genel bilgiler, güncel analiz metotları ekipmanı, dekontaminasyon teknikleri ve kimyasal ajanlara maruz kalındığında kullanılan farmasötik formülasyonlar tartışılacaktır.
Sonuç ve Tartışma: Kitle imha silahları arasında kimyasal savaş ajanları, biyolojik ve nükleer silahlara göre insanlığın yarattığı en acımasız tehlikelerden biridir. Günlük hayatımızda kolayca elde edilme imkânı olan kimyasallar ile bu savaş ajanları çok ucuz bir şekilde üretilebilir ve küçük terörist gruplar tarafından bile az miktarlarda kitlesel zayiatlar yaratabilir. Kimyasal savaş ajanları vücuda çeşitli yollardan girer; semptomlar buna göre değişebilir. Solunduğunda gazlar, buharlar ve aerosoller, burun ve ağız mukozasından akciğerlerin alveollerine kadar solunum yolunun herhangi bir kısmından emilebilir. Göz ayrıca bu ajanları doğrudan emebilir. Sıvı damlacıkları ve katı partiküller ise, deri ve mukoza zarlarının yüzeyinden emilebilir. Deri üzerinde karakteristik bir etkiye sahip toksik bileşikler, cilt üzerinde katı veya sıvı partiküller halinde biriktiklerinde etkilerini gösterebilirler. Bazı uçucu özellikteki maddelerin buharı sağlam cilde nüfuz edebilir ve bunu takiben zehirlenmeye neden olabilir. Yaralar veya sıyrıklar, sağlam deriye göre daha geçirgendir. Kimyasal savaş ajanları, yiyecek ve içecekleri kontamine edebilir ve dolayısıyla gastrointestinal sistem tarafından absorbe edilebilir. Kimyasal savaş ajanları çeşitli transmukozal yollarla nüfuz ederken, yüzeylerde tahriş veya hasarda oluşturabilirler. Ayrıca çevreye sızan zehirli maddeler yer altı suyunu, toprağı ve havayı kirletebilir ve canlı organizmalar üzerinde uzun süreli zararlı etkilere yol açabilir.

Anahtar Kelimeler

Biyoterörizm, dekontaminasyon, ilaç tedavisi, kimyasal savaş ajanları

Kaynakça

• 1. Aas, P. (2003). The threat of mid-spectrum chemical warfare agents. Prehospital and Disaster Medicine, 18, 306- 312. [CrossRef]
• 2. Convention on the Prohibition of the Development, Production, Stockpiling and use of Chemical Weapons and Destruction, Technical Secretariat of Organization for Prohibition of Chemical Weapons Web site. Erişim Adresi: http://www. opcw.org. Erişim tarihi: 2 Mayıs 2021.
• 3. Smart, J.K. (1997). History of Chemical and Biological Warfare: An American Perspective. In: Sidell, F.R., Takafuji, E.T., Franz, D.R., (eds): Medical Aspects of Chemical and Biological Warfare, Washington, (pp. 15). DC: Office of the Surgeon General.
• 4. Riley, B. (2003). The toxicology and treatment of injuries from chemical warfare agents. Current Anaesthesia & Critical Care, 14, 149-154. [CrossRef]
• 5. Okumura, T., Suzuki, K., Fukuda, A. (1998). The Tokyo subway sarin attack: Disaster management. Part 2: Hospital response. Academic Emergency Medicine, 5, 618-624. [CrossRef]
• 6. Stock, T., Haug, M., Radler, P. (1997). Chemical and biological weapon developments and arms control. In: Armaments, disarmament and International security, Stockholm, International Peace Research Institute Yearbook 1996, London: Oxford University Press; p. 661.
• 7. Schwenk, M., Kluge, S., Jaroni, H. (2005). Toxicological aspects of preparedness and aftercare for chemical-incidents. Toxicology, 214, 232-248. [CrossRef]
• 8. Makarovsky, I., Markel, G., Hoffman, A., Schein, O., Finkelstien, A., Nissimov, T.B., Tashma, Z., Dushnitsky, T., Eisenkraft, A. (2007). Osmium Tetroxide: A new kind of weapon. Israil Medical Association Journal, 9, 750-762.
• 9. Small, L. (2002). Master Thesis.Toxic industrial chemicals: A future weapons of mass destruction threat. In: US Government Reports Announcements and Index. Boston University, Boston, Massachussetts, USA.
• 10. Tu, A.T. (2000). Overview of sarin terrorist attacks on Japan. American Chemical Society Symposium Series, 745, 304.
• 11. Patocka, J., Fusek, J. (2004). Chemical agents and chemical terrorism. Central European Journal of Public Health, 12, S75-7.
• 12. Volans, G.N., Karalliedde, L. (2002). Long term effects of chemical weapons. Lancet, 360, S35-S36. [CrossRef]
• 13. Heymann, W.R. (2004). Threats of biological and chemical warfare on civilian populations. Journal of the American Academy of Dermatology, 51, 452-453. [CrossRef]
• 14. Ganesan, K., Raza, S.K., Vijayaraghavan, R. (2010). Chemical warfare agents. Journal of Pharmacy and Bioallied Sciences, 3, 166-78. [CrossRef]
• 15. López-Muñoz, F., Alamo, C., Guerra, J.A., García-García, P. (2008). The development of neurotoxic agents as chemical weapons during the National Socialist period in Germany. Revue Neurology, 47, 99-106.
• 16. Stuart, J.A., Ursano, R.J., Fullerton, C.S., Norwood, A.E., Murray, K. (2003). Belief in exposure to terrorist agents: Reported exposure to nerve or mustard gas by Gulf War veterans. Journal of Nervous and Mental Disease, 191, 431-6. [CrossRef]
• 17. Marrs, T.C., Maynard, R.L., Sidell, F.R. (1992). Chemical warfare agents Toxicology and Treatment, 2nd ed. John Wiley&Sons Ltd. England. p. 1-543.
• 18. Jokanović, M. (2009). Medical treatment of acute poisoning with organophosphorus and carbamate pesticides. Toxicology Letters, 190, 107-115. [CrossRef]
• 19. Marrs, T.C., Rice, P., Vale, J.A. (2006). The role of oximesin the treatment of nerve agent poisoning in civilian casualties. Toxicological Reviews, 25, 297-323. [CrossRef]
• 20. Shakarjian, M.P., Heck, D.E., Gray, J.P., Sinko, P.J., Gordon, M.K., Casillas, R.P., Heindel, N.D., Gerecke, D.R., Laskin, D.L., Laskin, J.D. (2010). Mechanisms mediating the vesicant actions of sulfur mustard after cutaneous exposure. Toxicological Sciences, 114, 5-19. [CrossRef]
• 21. Kehe, K., Szinicz, L. (2005). Medical aspects of sulphur mustard poisoning. Toxicology, 214, 198-209. [CrossRef]
• 22. Davis, K.G., Aspera, G. (2001). Exposure to liquid sulfur mustard. Annals of Emergency Medicine, 37, 653-656. [CrossRef]
• 23. Smith, W.J. (2009). Therapeutic options to treat sulfur mustard poisoning-the road ahead, Toxicology, 263, 70-73. [CrossRef]
• 24. Boyd, V.L., Harbell, J.W., O’Connor, R.J., McGown, E.L. (1989). 2,3-Dithioerythritol, a possible new arsenic antidote. Chemical Research in Toxicology, 2, 301-306. [CrossRef]
• 25. Cummings, T.F. (2004) The treatment of cyanide poisoning. Occupational Medicine, 54, 82-85. [CrossRef]
• 26. Raza, S.K., Jaiswal, D.K. (1994). Mechanism of cyanide toxicity and efficacy of its antidotes. Defence Science Journal, 44, 331. [CrossRef]
• 27. Cucinell, S.A. (1974). Review of the toxicity of long-term phosgene exposure. Archives of Environmental & Health, 28, 272-275. [CrossRef]
• 28. Diller, W.F., Zante, R.A. (1985). A literature Review: therapy for phosgene poisoning. Toxicology and Industrial Health, 1, 117-128. [CrossRef]
• 29. Beswick, F.W. (1983). Chemical agents used in riot control and warfare. Human Toxicology, 2(2), 247-256. [CrossRef]
• 30. Rengstorff, R.H. (1969). Tear gas and riot control agents: A review of eye effects. World Optometry Week, 60, 25-28.
• 31. Olajos, E.J., Salem, H. (2001). Riot Control Agents: Pharmacology, toxicology, biochemistry and chemistry. Journal of Applied Toxicology. 21, 355-391. [CrossRef]
• 32. Kinston, W., Rosser, R. (1974). Disaster: Effects on mental and physical state. Journal of Psychosomatic Research, 18, 437-456. [CrossRef]
• 33. Hofmann, A. (1971). Teonanácatl and Ololiuqui, two ancient magic drugs of Mexico. Bulletin Narcotics, 23, 3-14.
• 34. Bigalke, H., Rummel, A. (2005). Medical aspects of toxin weapons. Toxicology. 214(3), 210-220. [CrossRef]
• 35. Gill, D.M. (1982). Bacterial toxins: A table of lethal amounts. Microbiological Reviews, 46(1), 86-94. [CrossRef]
• 36. Arnon, S.S., Schechter, R., Inglesby, T.V., Henderson, D.A., Bartlett, J.G., Ascher, M.S., Eitzen, E., Fİne, A.D., Hauer, J., Layton, M., Lillibridge, S., Osterholm, M.T., O’Toole, T., Parker, G., Perl, T.M., Russell, P.K., Swerdlow, D.L., Tonat, K. (1978). Botulinum toxin as a biological weapon: Medical and public health management. Journal of the American Medical Association, 285(8), 1059-1070. [CrossRef]
• 37. Albin, R.L. (2000). Basal ganglia neurotoxins. Neurological Clinics, 18(3), 665-680. [CrossRef]
• 38. Pearson, G.S. (1999). The Unscom saga: Chemical and biological weapons non-proliferation, London: MacMillan Press Ltd, p.82-126.
• 39. Martin, C.O., Adams, H.P.Jr. (2003). Neurological aspects of biological and chemical terrorism: A review for neurologists. Archives Neurology, 60, 21-25. [CrossRef]
• 40. Boente-Juncal, A., Otero, P., Rodríguez, I., Camiña, M., Rodriguez-Vieytes, M., Vale, C., Botana, L.M. (2020). Oral Chronic Toxicity of the Safe Tetrodotoxin Dose Proposed by the European Food Safety Authority and Its Additive Effect with Saxitoxin. Toxins, 12(5), 312. [CrossRef]
• 41. Sun, Y., Ong, K.Y. (2005). Detection Technologies for Chemical Warfare Agents and Toxic Vapors, Boca Raton FL: CRC Press, pp.8-32.
• 42. Collins, D.C., Lee, M.L. (2002). Developments in ion mobility spectrometry-mass spectrometry. Analytical and Bioanalytical Chemistry, 372(1), 66-73. [CrossRef]
• 43. Makas, A.L., Troshkov, M.L. (2004). Field gas chromatography-mass spectrometry for fast analysis. Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, 800, 55-61. [CrossRef]
• 44. Sun, Y., Ong, K.Y. (2005). Detection Technologies for Chemical Warfare Agents and Toxic Vapors. Boca Raton FL: CRC Press, p.1-288.
• 45. Boopathi, M., Singh, B., Vijayaraghavan, R. (2008). A review on NBC body protective clothing. Open Textile Journal, 1, 1-10. [CrossRef]
• 46. Chan, J.T., Yeung, R.S., Tang, S.Y. (2002). Hospital preparedness for chemical and biological incidents in Hong Kong. Hong Kong Medical Journal, 8, 440-446.
• 47. Amitai, G., Murata, H., Andersen, J.D., Koepsel, R.R., Russell, A.J. (2010). Decontamination of chemical and biological warfare agents with a single multi-functional material. Biomaterials, 31, 4417-25. [CrossRef]
• 48. Kumar, V., Goel, R., Chawla, R., Silambarasan, M., Kumar Sharma, R. (2010). Chemical, biological, radiological, and nuclear decontamination: Recent trends and future perspective. Journal of Pharmacy & Bioallied Sciences, 3, 220-38. [CrossRef]
• 49. WHO, Annex 1 - Chemical Agents. In: Public Health Response to Biological and Chemical Weapons, WHO Guidance, Geneva: World Health Organization; (2004). Erişim adresi: http://www.who.int/csr/delibepidemics/biochemguide/en/ Erişim tarihi: 10.01.2021.