PYRIDOSTIGMINE BROMIDE TABLETS

File: 970815_may96_decls15_0001.txt
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Subject = PYRIDOSTIGMINE BROMIDE TABLETS                                  

Parent Organization = XVIII CORPS 

Unit = 24TH ID     

Folder Title = MISC INFORMATION PAPERS                                                                         

Document Number =         41

Box ID = BX001429










                                                          AFZP-MD
                                                          17 January 1991

                                INFORKATION PAPER

      SUBUECT: Pyridosticjmine Bromide Tablets

      1. Purpose: To outline purpose and function of pyridostigmine
      bromide (PB) tablets.

      2. Facts:

          a.  Pyridosticjmine Bromide (PB) tablets, also referred to as
              Nerve Agent Pyridostigmine Pre-treatment (NAPP) are part of
              the medical defense against nerve agent exposure. The
              mechanism of action is to partially "protect" the target
              enzyme in the body from nerve agent. When used alone, it
              does not prevent nerve agent injury after exposure, but
              instead enhances the drug therapy provided by the
              standard use of the MARK I kit. It is primarily effective
              against Soman (GD). Studies indicate that PB pretreatment
              with MARK I kit administration will raise the amount of
              nerve agent required as a lethal dose as much as 25 times,
              markedly increasing survivability.

          b.  The unit of issue is the blister pack, which contains
              21 tablets (30 mg each), a 7 day supply. The dose is one
              (1) tablet every 8 hours, and if doses are missed, two
              tablets as a "make-up" dose should NOT be given. Instead,
              resumption of an every 8 hour schedule is preferred.      The
              onset of action is I - 3 hours and use can continue for up
              to 3 weeks before medical reevaluation is required.

          c.  Side effects are minimal, occurring in less than I % of
              personnel and include mild stomach cramps, nausea,
              weakness, muscle cramps, diarrhea and skin rash. In studies
              using healthy volunteers, PB did not cause any degradation
              of performance when given at prescribed doses. Furthermore,
              it is safe to take with other medications. Consult medical
              personnel if significant symptoms occur.

          d.  Decisions as to the initiation and cessation of use remain
              with command.

      3. POC  is CPT Long, Division Surgeon's Office, 9-7663-144.



                                         J. BENJAMIN RXLL/Division Surgeon