Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Wenger, 1993 | 7 | Healthy male soldiers age 22±2.8 Placebo controlled partial-double-blind crossover with 7 d phases after heat acclimation |
30 mg q8 hr for 19 doses, or placebo | PB caused a modest increase in whole-body sweating and reduced skin temperature on the chest during exercise by 0.5-0.9° C. Trend toward increased rectal temperature "Near lack of adverse effects" |
Wenger, 1992; Wenger, 1992 |
6 | Healthy male soldiers, age 25.6�9.6: test outcomes with heat, exercise, and hypohydration | PB 30 mg tab or placebo | "PB had only minor effects on tolerance to moderate exercise-heat stress and did not aggravate the strain of hypohydration" Rectal temperature: PB reduced rise in Tre but significant only during hypohydration Skin temperature on chest: decreased with exercise at 20% rh, more with PB, significant only in condition 2 Skin temperature on upper arm: no difference? Skin temperature on calf: No difference Heart rate: lowered 3 beats/min (p = .004) PB decreased expansion of plasma volume that occurred during heat exposure: significant only at 75% rh | Roberts, 1994 | 7 | Healthy male | No change in thermoregulation during exercise in cold air |
Roach, 1991 | 30 | 10 nonsmokers, 10 smokers, and 10 mild asthmaticsDouble-blind placebo-controlled crossover with PB or placebo before bronchoprovocation | 30 mg q8 hr | No effect of PB on nonspecific bronchial hyperreactivity in normals, smokers, or asthmatics |
Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Ram, 1991 | 25 | 12 healthy and 13 asthmatic | 60 mg once30 mg | Statistically but not physiologically significant decrease in FEV1 at rest (p < .015) and with exercise (p < .05), strongly correlated to degree of AChE inhibitor (p < .00001) AChE inhibition: 28% with 60 mg; 23% with 30 mgPulse: significantly reduced (p < .005) Respiratory function: no change Cannot preclude more vulnerable subpopulation of asthmatics |
Arad, 1992 | 8 | Hypertensive patients on beta-blockers Randomized double-blind crossover PB or placebo for 2 days |
30 mg tid for 2 days | No clinical adverse effects of PB No significant effect on heart rate, plasma catecholamine level, or resting blood pressure Lower diastolic blood pressure with PB with exercise (average decrease 5 mm Hg versus placebo, p < .01) |
Epstein, 1990 | 8 | Male heat-acclimatized volunteers, age 23.5±1.1 Randomized double-blind crossover with subjects exposed to 170 min of exercise heat stress (relative humidity 60%, Tdb 33° C) |
30 mg q8 hr for 4 doses versus placebo | Average 33% whole blood cholinesterase inhibition 4 hr after last tablet Higher non-evaporative heat exchange with PB (p < .03) No difference in heart rate, rectal temperature, heat storage, and sweat rate with PB versus placebo |
Levine, 1991 | 10 | Healthy male soldiers Counterbalanced drug and control: 2 days tested with drug, 2 with placebo Not stated to be blinded |
PB 30 mg tab once, or placebo; test days separated by = 48 hr | No change in pulmonary function tests with PB: FEV1, FVC, maximum voluntary ventilation in 15 seconds, carbon dioxide sensitivity, or maximum inspiratory or expiratory flow rates |
Levine, 1991 | 7 | Healthy male soldiers Counterbalanced drug and control: 2 days tested with drug, 2 with placebo Not stated to be blinded |
PB 30 mg tab once or placebo; test days separated by = 48 hr | No significant change in skeletal muscle strength (peak hand-grip strength and 60% peak hand-grip endurance time, peak torque for leg extension), and muscle tissue damage by serum enzymes |
Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Kolka, 1991 | Placebo-controlled crossover | PB 30 mg po tid | PB lowers esophageal temperature and HR in hot environment; HR in warm environment | |
5 | Healthy males age 20�2 tested at rest, 2 hr after PB, and 2 hr p seventh PB tab in hot environment | Reduced resting esophageal temperature and heart rate with PB (p <.05) no change in arterial blood pressure, forearm blood flow and forearm skin blood flow; *74 hr data presented for a mean of only 3 of the 5 subjects because PB was discontinued in 2 due to high red blood cell AChE inhibition | ||
4 | Healthy males age 19.4±0.5 tested (a) control at sea level (b) control at 10,000 feet; (c) 2 hr after first PB at 10,000 feet; (d) 26 hr after first and 2 hr after fourth PB tab; (e) sea level 2 hr after tenth tab Tested in warm environment at sea level and 10,000 feet | Lower esophageal temperature (trend only) at sea level HR lower at sea level 74 hr after PB |
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Stephenson, 1989; | 5 | Healthy adult males | PB 30 mg po or no drug, 150 min before | 40% decrease red blood cell AChE (329%�7) |
Stephenson, 1990;Kolka, 1990 | 4 | PB decreased skin blood flow; PB decreased heart rate at rest and in exercise Esophageal temperature: increased with exercise only with PB 8-site mean skin temperature Forearm blood flow (venous occlusion plethysmography): no change Cutaneous perfusion (laser doppler velocimetry): reduced 37% after PB (p = .05) with higher temperature threshold for initiation of cutaneous perfusion of PB (p = .01) Slope of LDV: esophageal temperature was reduced 35% with PB (p = 0.22) Metabolic rate (indirect calorimetry) |
Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Arad, 1992 | 8 | Healthy males | 30 mg q8 hr for 4 doses | No significant effect of PB, protective gear, or interactions on performance of vertical addition, reaction time, or perceptual speed |
Forster, 1994 | 5 | Healthy male members of human centrifuge acceleration pattern; age 26±3; weight 80±4 kg | 30 mg q8 hr or placebo | PB level range: 6-31 ng/ml
AChE inhibitor range: 12-45% No significant differences in ratings for fatigue, symptoms, and work effort; grip strength; tapping task Sternberg memory search; critical tracking, Dual Sternberg, and tracking pulmonary function tests; Acceleration tolerance; heart rate, QT interval, PR interval |
Borland, 1985 | 4 | Healthy male 19-27 years Crossover; double-blind crossover |
PB 30 mg q8 hr for 3 days or placebo | "Minimal if any effects" Increased mean critical flicker fusion; impaired visuomotor coordination performance; no changes in mood, mean choice reaction time; grating contrast sensitivity; macular thresholds, digit symbol substitution, symbol copying; quantitative kinetic perimetry, EEG during mental arithmetic |
Wiley, 1992 | 4 | Healthy aviators | PB 30 mg q8 hr for 3 days after baseline measurements | Visual ability "not significantly compromised"; refractive error and pupil diameter significantly different, but no change in lateral phoria, fusional vergence, accommodative amplitude with PB |
Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Izraeli, 1990 | 10 | Pilots experienced in actual and simulated A-4 flights Double-blind placebo-controlled crossover |
PB 30 mg q8 hr | No decrement in performance under treatment with PB |
Brooks, 1992 | 24 | A-10 pilots Crossover counterbalanced double-blind trial of performance with PB versus placebo |
PB 30 mg tid versus placebo | No operationally significant effects of PB. No clear interference of PB with performance |
Author |
Sample Size | Sample/Study Characteristics | Dose | Findings |
Sharabi, Danon, et al., 1991 | 213 | Male Israeli soldiers 18-22, retrospective cohort | 30 mg q8 hr | No correlation between AChE inhibition and type or severity of symptoms Malaise: 53% Fatigue, numbness: 37% Headache: 29% Dizziness, imbalance: 19% Moodiness: 18% Restlessness: 18% Heavy extremities: 10% Excessive sweating: 9% Altered mood: 8% Sense of fear: 6% GI: Dry mouth: 71% Nausea: 22% Abdominal pain: 20% Lack of appetite: 14% Diarrhea: 6% Other: Hot flushes: 20% Rhinorrhea: 10% Rapid heart beats: 8% Frequent urination: 11% |
Keeler, 1991 | "Approximately 30" | Retrospective survey of proxy recollection by medical support personnel involved with 41,650 soldiers in PGW | 30 mg q8 hr | GI symptoms: 50% Urinary: 5�30% Headache, rhinorrhea, diaphoresis, tingling of extremities: < 5% Need for medical visit: 1% Discontinuation on medical advice: < 0.1% |
Author | Sample Size | Sample/Study Characteristics | Dose | Findings |
Kennedy, 1991 | 1 | Case report of PGW medical officer (letter to editor) | 30 mg q8 hr | Esophageal spasm with chest pain and trouble swallowing Reports of others' abdominal and skeletal muscle cramps, increased bowel gas, blurred vision, and one claim of a 36-hour erection |
Almog, 1991 | 9 | Observational report of 9 cases of PB overdose | 13 to 39 PB tabs | Muscarinic: abdominal cramps, diarrhea, nausea, vomiting, salivation, urinary incontinence (lacrimation and sweating not prominent) Nicotinic symptoms: transient fasciculations and muscle weakness Central symptoms: (not seen: ataxia, confusion, psychosis, respiratory or cardiovascular depression, seizure, coma) No relation between symptoms and AChE inhibition; major symptoms resolved in several hours while cholinesterase returned to normal in 1-2 days |