Nerve Agents

Clinical Signs and Symptoms

Signs Symptoms

Clinical Signs and Symptoms

Nerve agent's primary means of inducing toxicity is through inhalation and skin/eye contact. Occasionally ingestion can occur.

The onset of action with inhaled vapor can be almost instantaneous causing local and systemic effects. Liquid which is readily absorbed thru the skin can cause system effects in minutes and up to 18 hours later.

  • Respiratory: Inhalation of nerve agent vapor causes respiratory tract effects within seconds to minutes. Symptoms include increased, rhinorrhea, and bronchial secretions, chest tightness secondary to bronchial muscle contraction.
  • CNS: High dose - seizures, loss of consciousness, apnea. Other signs and symptoms include; irritability, memory loss, fatigue, memory loss, behavioral and psychological changes.
  • Cardiovascular: Potentially up to three phases in variable length - transient tachycardia/with or without hypertension (minutes) followed by bradycardia and hypotension. The final phase starts hours to days after exposure with QT prolongation and a tendency toward malignant dysrhythmias. In one Organophosphate toxicity study 42 % had cardiac arrhythmias with torsades de pointe occurring in 37 % of the cases.
  • Gastrointestinal: Abdominal pain, N&V, diarrhea are common manifestations of any exposure. It may be the first systemic effects of skin exposure. If GI symptoms occur within one hour of dermal contamination severe intoxication is present.
  • Skeletal Muscles; Nerve agents stimulate skeletal muscles producing twitching and fasciculations. This leads to fatigue and flaccid paralysis.
  • Metabolic: Sweating.
  • Ocular: Symptoms may occur from local effects secondary to vapor exposure or as a manifestation of systemic absorption. Pinpoint pupils, eye pain, conjunctivitis, and increased tearing are common (with systemic absorption pinpoint pupils may not occur immediately).
  • Link to Toxic Syndromes
  • Link to Primary and Secondary Survey
Find more information on this substance at: PubChem, PubMed