ISSUE OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT

File: 970815_sep96_decls25_0002.txt
Page: 0002
Total Pages: 3
Subject = ISSUE OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT                

Parent Organization = MISC        

Unit = MISC        

Folder Title = CHEMICAL WARFARE ISSUES                                                                         

Document Number =         11

Box ID = BX005619




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   PAGE 33 RUD-@HAA0120
   REACTIONS. ALTHOUG4   14 0 DETRI%IENTAL EFFECTS ARE EXPECTED AT THE
   RECJMAENDED DOSAGE# DEPENDING ON LENGTH OF T14E AND AMOUNT )F
   MEDICATION TAKEN ALONG WIT4 INDIVIDUAL PSYSI-3LOGICAL VARIAT104SP
   CERTAIN INDIVIDUALS MAY EXPERIENCE THE FOLLOWING ADVERSE REACTIONS
   FROM PYRIDOSTIGMINE:    ABDOMINAL CRAMPS# NAUSE&T DIARRHEA# SKIN RASHP
   OEAKNESS# MUSCLE CRAMPS, MUSCULAR TWITCHING AND/OR DIMNESS OF VISION
   DOE TJ PINPOINTED PUPILS, IF ANY OF THESE SIG4S/SYMPTOMS OCCJRP THE
   S.)LDTER S40JLD CHECK WITH 4EDICAL PERS0414EL,
   D.    (U) EMERGENCY MEDICAL TREATMENT ADMINISTERED FOR PYRIDOSTIGMINE
   SIDE EFFECTS,    ORDINARILY DISCONTINUING PYRIDUSTIGMINE SHOULD BE
   ADEQUATE TO ALLEVIATE SIGN;@SYMPT3mS, PYRIDOSTIGMINE MAY PERSIST IN
   TIF BL.DUD FOR 24 4OURS# M04EVER# AFTER BLOOD LEVELS PEAK IN 4 HOURS,
   EFFECTS D14141SH GRADUALLY, EMERGENCY TREATAENT INCLUDES
   ADmINIS7ERING ATROPINE IN DOSES SUFFICIENT TD OVERCOME THE
   C40LIlERGIC CRISIS.. USE OF TIE 2-MG ATROPINE SHOJLD BE ADMINISTERED
   BY ME)ICAL PERSONNEL EVERY @IFTEEN-TWENTY (15-20) MINUTES. SEVERE
   CASES MAY REGUIRE ASSISTED VE4TILATION BIIT WOULD BE UNUSUAL IF THE
   EIGHT HOUR ADMINISTERED DOSE HAD BEEN FOLLOWED, WHEN STABILIZFDP
   THE CKSUALITY MAY NEED EVACJAIIDN FDR FURTriER OBSERVATION 44D
   TREATIlEtYT.




   PAGE 34 RUDCHAA012            6
   Et    (U) USE OF PYRIDDSTIG%,114E PRETREATMENT IN AIRCREW PERSONNEL
         1. AT DIREC713N OF CD-@NIZANT COMMANDER* ALL PERSONNEL INCLUDING
   DESIG4ATED 4IRCREoi KILL TAKE PyRrDOSTIG41NE AS OUTLINED INPREVIDUS
   PARAS.
         a. AIRCREA MAY FLY IMMEDIATELY.
         $. FLIGHT SURGEONS WILL CLOSELY M)NITDR ALL AIRCREWS TAKING
   PYRID3STIGMINE INCLUDINGP AS FAR AS POSSIBLE# DAILY CONTACT WITH EACH
   CREN AEMBER.
         S.   FLIGHT SURGEONS AVD AVIATIDN MEDICAL SAFETY OFFICERS SHOULD
   BEGIN BRIEFING ATRCREVIS ASAD C014CERNrNG USE A4D POTENTIAL SIDE
   EFFECTS OF PYRID35TIG?41NE, EMPHASIS TO BE PLACED ON POTENTIAL'
   VISJA,..14PALR%4E.,iT, PARTICULARLY AT NIGHTP AS qELL AS DECREASE IN HEAT
   TOLERANCE.
         5. PRETESTING AVIATION PERSONNLL IS NOT REQUIRED TO DETERMINE
   ADVERSE EFFECTS,
   F,    (U) RESPONSIBILITIES'. LI)WEST LEVEL CHAIN OF COMMAND KILL
   DECIDE TO BEGIN* CONTINUE OR DISCONTINUE T4E SAPP PRETREATMENT
   MEDICATION BASED ON THREAT. INTELLIGENCE OFFICERS AND MEDICAL
   PERS04NEL k@@T AS ADVISORS TO THE CDm4AN)ER IN MAKING HIS DECISION
   IF A CHEMICAL THREAT EXISTS. AFTER THREE DAYS OF USING NAPP



   PAGE 35 RUDC4AAOI@0'rT'r'r'E'-T
   CJM4A4DER A14D STAFF SHOULD REEVALUATE COMBAT SITUATION TO DETER41NE
   IF 4E)ICATIJM SHOJLD BE C04TIlUED OR DISCONTINUED. PRETREATMENT CAN
   BEGIN AT 44Y TIME DEPENDING ON THE SITUATION, IF PRETREATMENT is
   CDNTIVUED FOR SEVEN DAYSP 44 ADDITIONAL NAPP MUST BE ISSUED AND
   ADDITIDNAL PACKS ORDERED. ADAINISTERING THE 4EDICATION BEYOND



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