Most of us in the health care field will recall the fact that terrorists in Japan wrecked havoc when they exploded a few crude sarin nerve gas bombs on the Japanese subway system. Scores of people were killed and millions were inconvenienced.
Scientists of The U.S. Army Medical Research Institute of Chemical Defence and the Army Research and Material Command located in Maryland have made some interesting discoveries while experimenting with male guinea pigs. They administered large doses of sarin and soman werve gas to guinea pigs. As if this was not enough they also administered an organophosphate (pesticide) paraxon to the guinea pigs. As an antidote the guinea pigs were given Reminyl (now, more often called Razadyne). Surprisingly, the guinea pigs, all of them male, survived with no apparent ill effects. All of us know that each one of these poisons is sufficient to kill.
The scientists concluded that the Super Survival of the guinea pigs was attributed to the fact that they were administered large doses galatamine hydrobromide (Reminyl). Most of us, who are nurses will recall that this drug is used, very commonly, for the management of “Alzheimers Disease”. It seems that this medication was able to prevent soman, sarin and the organophosphates from penetrating the blood brain barrier.
“Reminyl” has had a recent name change. It is now called Razadyne. In the U.S. approximately four and one half million Americans use it. It is easily available and is frequently prescribed. It is one of a group of drugs called "cholinesterase inhibitors".
With this discovery, terrorists will not be able to kill, maim or threathen innocent people with at least these chemicals anymore. Galatamine hydrobromide seems to be an effective antidote for Soman, Sarin and certain organophosphates.
The easy availability means that in the event of an emergency the drug can be obtained from civilian resources for military and medical applicants. Further, since many of the side effects of this medication are already known, it can be used as an antidote in suspected situations where the benefits out weigh the known risks. Currently, the known side effects are as outlined below:
Most common side effect: Abdominal pain, anaemia, blood in urine, depression, diarrhea, dizziness, fatigue, headache, inability to sleep, indigestion, loss of appetite, nausea, runny nose, sleepiness, tremor, abdominal pain, urinary tract infection, vomiting, weight loss
Less common side effects may include: Chest pain, dizziness, fainting, gas, incontinence, slow heartbeat
Rare side effects may include: Apathy, black stools, convulsions, delirium, difficulty swallowing, drooling, dry mouth, frequent urination, heart failure, hiccup, inability to comprehend language, increased sex drive, formation of kidney stones, and hypotension.
Since this discovery it is possible that Galatamine hydrobromide will be added to the arsenal of medications supplied to the Army, Navy and the Air force because they are usually the first responders. Ambulance crew, nurses in Emergency Departments may be required to keep a supply for emergency use.
Symptoms of Reminyl overdose may include: Convulsions, drooling, fainting, incontinence, low blood pressure, muscle weakness, severe nausea, slow or irregular heartbeat, stomach cramps, sweating, teary eyes, twitching, weak breathing, vomiting.
In conclusion, it must be clarified that the meaning of large doses is not clear because the researchers did not release this information. The normal dose of Reminyl is 4 milligrams twice a day. Four weeks later, the dose is normally increased to 8 milligrams twice a day. After waiting an additional four weeks, the doctor may increase the dose to 12 milligrams twice a day if necessary. This is a medical decision.
For patients with mild to moderate liver problems and kidney problems, dosage should not exceed 16 milligrams per day.
It must be used with caution if the patient is an asthmatic.
