Hakan YAREN, LEVENT KENAR, Turan KARAYILANOĞLU

Önemli bir kimyasal silah grubu: Sinir ajanları

Özet: Modern kimyanın gelişimi sonucunda ortaya çıkan etkin kimyasal silahların en önemli gruplarından bir tanesini oluşturan ve II. Dünya savaşı öncesi geliştirilen sinir ajanları, toksik ve klinik etkilerini kolinerjik kavşaklarda bulunan asetilkolinesteraz enzimini geri dönüşümsüz olarak inhibe ederek ve asetilkolinin aşırı miktarda birikimine neden olarak gerçekleştirirler. Klinik belirtiler; muskarinik (sekretuar bezlerin stimulasyonu, miyozis, solunum sıkıntısı vb), nikotinik (iskelet kaslarında aşırı stimülasyon, tremor flask paralizi vb.) ve santral sinir sistemi (konvülziyonlar, bilinç kaybı, koma vb.) alanlarının etkilenimi ile oluşur. Sinir ajanı maruziyetinde tedavi yaklaşımı; solunum desteği, dekontaminasyon, antidot tedavisi (atropin, oksim, diazepam, pridostigmin bromür) ve destek tedavisi aşamalarını içerir. Dünyanın mevcut konjonktürüne bağlı olarak artan kimyasal ajan kullanımı olasılığı nedeniyle, sağlık personelinin sinir ajanları, etkileri ve maruz kalmış yaralıların tedavisi hakkında bilgi sahibi olması bir gereklilik haline gelmiştir

Anahtar Kelimeler:

Panzehirler, İlaçların fizyolojik etkileri, Oksimler, Kimyasal savaş ajanları, Sinir sistemi

An important chemical weapon group: Nerve agents

Abstract: As a result of developing modern chemistry, nerve agents, which are one of the most important group of efficient chemical warfare agents, were developed just before Second World War. They generate toxic and clinical effects via inhibiting acetylcholinesterase irreversibly and causing excessive amounts of acetylcholine at cholinergic synapses in the body. Clinical symptoms are occurred as a result of affected muscarinic (stimulation of secretuar glands, miosis, breathing problems etc.), nicotinic (stimulation of skeletal muscles, paralyse, tremors etc.) and central nerve system (convulsions, loss of consciousness, coma etc.) areas. In case of a nerve agent exposure, treatment includes the steps of ventilation, decontamination, antidotal treatment (atropine, oximes, diazepam and pyridostigmine bromide) and supportive theraphy. Because of arising possibility of using chemical warfare agents due to current conjuncture of the world, medical staff should know about nerve agents, their effects and how to treat the casualties exposured to nerve agents.

Keywords:

Antidotes, Physiological Effects of Drugs, Oximes, Chemical Warfare Agents, Nervous System,

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