TREATMENT OF NAPP OVERDOSE 26 DEC 90

File: 123096_sep96_decls4_0001.txt
Page: 0001
Total Pages: 2

Subject: TREATMENT OF NAPP OVERDOSE    26 DEC 90                         

Unit: VAR. BUMED  

Parent Organization: BUMED       

Box  ID: BX303902

Folder Title: TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE                                   

Document Number:          1

Folder Seq  #:          7





                                        UNCLASSIFIED




                                  UNITED STATES MARINE CORPS
                              3RD Marine Aircraft Wing, FMFPAC
                              FPO San Francisco, CA 96608-6001

                                                                       6000
                                                                       MED
                                                                       26 Dec 90
             MEMORANDUM

             From:   Wing Surgeon, Third Marine Aircraft Wing, FMFPAC
             To:     Distribution

             Subj:   TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT
                     (NA,PP) OVERDOSE

             Ref:    (a) Phone conversation between CDR Clark, 3rd KAW
                     Medical, and COL Wade, CENTCOM Medical, IS Dec 90.

             1. Nerve Agent Pyridostignine Pretreatment (NAPP) consist of,a,
             blister pack of twenty-one (21) 30mg Pyridostigmine tablets.
             2. Pyri(;ostigmine, taken in advance of exposure to chemical
             agents, enhances the antidote effectiveness of the Mark 1
             Antidote Kits. The Pyrodostigmine dose should never exceed one
             (1) tablet (30mg) in any 8-hour period. Although rare at this
             dosage, minor side effects may be encountered (increased
             flatus, loose stools, and slight drop in heart rate). If
             tablets are taken more frequently than every eight (8) hours or
             more than one at a time, symptoms similar to nerve agent
             exposure wiii appear but are reversible with timely medical
             treatment.

             3. Although there is no recognized abuse potential, it is
             possible that NAPP could be taken as a suicide gesture/attempt.
             As stated above, signs and symptoms would be similar to nerve
             agent exposure, characterized by parasympathetic hyperactivity
amps, nausea, vomiting,
             salivation, lacrimation, tracheobronchial secretions,
             urination, excessive sweating, bronchoconstriction,
             bradycardia, AV conduction slowing, weakness, and pinpoint
             pupils), but CNS effects should not be a problem unless
             respiratory arrest from neuromuscular paralysis has resulted in
             coma leading to secondary CNS effects. Although not verified
             at this time, experts in chemical warfare are of the opinion
             that pyridostigmine overdose may induce vomiting and thereby
             limit the problem by evacuating the stomach of the ingested
             Pyridoktigmine (reference (a)).

             4. Pyridostigmine reaches peak level@-in blood at
             approximately 4 hours and has a half life of 6 hours.
             Depending on the amount of overdose, Pyridostignine could
             persist in the blood to some degree as long as 24-36 hours.



                                          UNCLASSIFIED

Document 2 f:/Week-44/BX303902/TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE/treatment of napp overdose 26 dec 90:1217960956163
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-44
Box ID = BX303902
Unit = VAR. BUMED
Parent Organization = BUMED
Folder Title = TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE
Folder Seq # = 7
Subject = TREATMENT OF NAPP OVERDOSE 26 DEC 90
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996