Thesis (M. Med. Sc.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 39-44).

Thesis (M.Med.Sc.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 39-44). Also available in print.

No description available.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

No description available.

This thesis is dedicated to the topic of the nerve agents with special emphasis on antidotal treatment utilizing application of the auto-injectors. Two methods were used ? literature research and quantitative research. Since this topic covers plenty of information as regards chemical warfare agents and in particular nerve agents these issues were addressed in the theoretical part of the thesis. In the chapter on current status based on literature resources a summary of evolution of the auto-injector is presented; from firsts notes until the situation today. Practical part of the thesis is concentrated on University of Southern Bohemia in ČeskéBudějovice, Faculty of Health and Social Studies students' knowledge in the area of nerve agents. The results of the research were acquired by the method of quantitative research ? questionnaires with 18 questions. With respect to each of the questions a selection of the 2 to 7 answers was offered to the students, whereas in every case only 1 answer was correct. The results were analyzed both with reference to each of the questions and with reference to each of the students. By this method it has been discovered that the respondents have a good knowledge in the area of nerve agents. Furthermore, the practical part of the thesis included an experiment concerning speed with which the respondents were able to apply antidotum with a training auto-injector by themselves with no prior instructions in comparison to how quickly they were able to do the same after being instructed. By this method were tested the quality of the instructions provided to the auto-injectors and its ergonomic qualities (intuitiveness of its application). Recorded times were statistically analyzed and the results, although materially different, were assessed as satisfactory.

Chemical warfare agents can be currently considered a high risk to humans. Group of nerve agents, is considered the most dangerous. These highly toxic substances have a rapid onset of action, the organism will receive all the entry gates, therapy intoxication is always difficult and death occurs often. The body's resistance to the effects of nerve agents at the expected intoxication increases not only prophylactic administration of antidotes , eg. when working in a contaminated environment after a terrorist attack, but also potentiates the subsequent antidotal therapy after exposure. This thesis is dedicated to gain in depth understanding of nerve agents with aspect of pharmacological prophylaxis. The introduction presents combat toxic substances in general, differentiation due to its effect on human with possible damage to the organism and brief characteristics of every basic type of nerve agents with examples included. Further on the theoretical part focuses on issues of nerve agents. The history of their development and well-known applicationsis breifly mentioned, respectively, abuse in the world. The thesis mentions of the Conventions on the prohibition of chemical weapons in connection with the misuse. Thesis continues dividing type nerve agents, describing the mechanism of action, acute toxicity and its symptoms, diagnosis and therapy of poisoning. Degree, extent and rate of damage to the body caused by nerve agents depends on many factors. A major factor which influences the ultimate toxic effect are taken input. Body damage can be caused, for example. Inhalation administration, contamination of broken or intact skin, ingestion, or hitting the conjunctiva. Since they have nerve agent toxicity and high speed action, protective and preventive measures are an important element to prevent the penetration of substances into the body. The Army of the Czech Republic ensures the protection of personal protective equipment, decontamination of affected skin and pharmacological prophylaxis. Another part of this work is the term prophylaxis and related topics, especially pharmacological prophylaxis. Directions pharmaceutical prophylaxis currently can be divided into three directions - protection against acetylcholinesterase inhibition, administration of antidotes and normal use Scavengers called. "Scavengers". The body's resistance to the effects of nerve agents at the expected intoxication not only increases prophylactic administration of antidotes, but also potentiates the subsequent antidotal therapy after exposure. Prophylactics PANPAL and TRANSANT are in equipment of Czech Army, in the work is devoted more attention to them. Both of these products were developed in the Czech Republic. There are also presented antidotal remedies of first aid, which are available for the Army of the Czech Republic. The practical part of this thesis aims to compare the prophylactic antidotes in the Czech Republic and in selected countries of NATO from four perspectives - onset, prophylactic activities, application forms, and adverse effects. An analysis of the available Czech and foreign professional articles, publications and studies and the subsequent comparative analysis of the various aspects and evaluate various selected countries is used to achieve this goal. These resulting data then point to the position of the Czech Republic in the field of prevention against intoxication by nerve agents - The Army of Czech Republic that has put in service two prophylactic antidotes that achieve the best results investigational products. It may therefore be said that the Army of the Czech Republic currently has a combination of prophylactic best in the world, which is relatively free of side effects has easy application and an unnecessarily long duration of action. This result is even answer the research question - Prophylactic antidotes in the Czech Republic are comparable according to the given parameters with antidotes in selected countries.

Orientador: Fábio Bucaretchi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T19:06:06Z (GMT). No. of bitstreams: 1 Fernandes_LucianeCristinaRodrigues_M.pdf: 3350609 bytes, checksum: 1749edf65ae7946299b707cd046715f2 (MD5) Previous issue date: 2014 / Resumo: Introdução: A carência de adequada e pronta disponibilidade de antídotos é um problema mundial, com consequências potencialmente desastrosas. Objetivo: Avaliar a disponibilidade de antídotos empregados no tratamento das intoxicações nos serviços de emergência públicos e privados da cidade de Campinas. Métodos: Um questionário estruturado foi encaminhado aos responsáveis por farmácias de serviços de emergência de Campinas-SP, públicos e privados, que compuseram a amostra. A disponibilidade, quantidade estocada, local de estoque, e tempo de acesso na sala de emergência (imediata ou dentro de uma hora) a 31 antídotos em 33 apresentações farmacêuticas foi pesquisada, considerando o estoque de pelo menos um tratamento completo por antídoto por serviço, para um adulto com peso estimado de 70 kg. A seleção dos antídotos se baseou em recomendações de estoque contidas em diretrizes internacionais publicadas até o final de 2009. Não foram incluídos na análise soros antiveneno de animais peçonhentos. Resultados: Os questionários foram completados por 14 de 17 serviços de emergência operantes à época, sendo 7 públicos e 7 privados. Nenhuma unidade de emergência dispunha de todos os 31 antídotos selecionados, e nenhuma dispunha de anticorpos antidigoxina, de fisostigmina, de fomepizole, de hidroxicobalamina ou de pralidoxima. Oito serviços contavam com estoque adequado de N-acetilcisteína, porém em apresentações pouco apropriadas para uso como antídotos (ex: solução injetável 3 mg/mL para uso IV; envelopes de 100 mg, 200 mg ou 600 mg para uso VO ou por tubagem nasogástrica). Apenas sete apresentações estavam estocadas em todas as unidades avaliadas (atropina, bicarbonato de sódio a 8,4%, diazepam, fitomenadiona, flumazenil, glicose a 50% e gluconato de cálcio a 10%), seguidas de 13/14 unidades onde também havia estoque de carvão ativado e naloxona. Apenas uma unidade de emergência, pública e de referência regional no tratamento de intoxicações, contava com um estoque próximo ao delineado, com 25 antídotos e 27 apresentações farmacêuticas, porém sem estoque de anticorpos antidigoxina, fisostigmina, fomepizole, hidroxicobalamina, glucagon e pralidoxima. Conclusões: O estoque de antídotos nos serviços de emergência na cidade de Campinas é insuficiente e mal dimensionado, colocando em risco o tratamento de pacientes intoxicados / Abstract: Introduction: The lack of adequate and prompt availability of antidotes is a worldwide problem, with potentially disastrous consequences. Objective: To evaluate the availability of antidotes used in the treatment of poisonings in public and private emergency departments in the municipality of Campinas. Methods: A structured questionnaire was sent to the pharmacy directors of the public and private emergency departments from the Campinas municipality. The availability, amount in stock, stocking place, and access time in the emergency room (immediately or in first hour) to 31 antidotes in 33 pharmaceutical preparations was investigated, considering the stock of at least one full antidote treatment per service per an adult with an estimated weight of 70 kg. . The selection of antidotes was based on stock recommendations contained in international guidelines published by the end of 2009. Antivenoms were not included in the analysis. Results: Questionnaires were completed by 14 of 17 emergency departments operating at the time, 7 public and 7 private. No emergency department had all the 31 selected antidotes, and none of them had antidigoxin antibodies, physostigmine, fomepizole, hydroxocobalamin, or pralidoxime. Eight units had adequate stock of N-acetylcysteine, but in inappropriate presentations for use as antidotes (injectable solution 3 mg / mL for IV use; 100 mg, 200 mg or 600 mg envelopes for use by oral or nasogastric tube). Only seven presentations were stocked in all evaluated units (atropine, sodium bicarbonate 8.4%, diazepam, phytonadione, flumazenil, glucose 50% and calcium gluconate 10%), followed by 13/14 units where there was stock of activated charcoal and naloxone. Only one referral public department emergency in the treatment of poisonings had stocks close to the one outlined with 25 antidotes and 27 pharmaceutical forms, but without antidigoxin antibodies, physostigmine, fomepizole, hydroxocobalamin, glucagon and pralidoxime in stock. Conclusions: The stock of antidotes in emergency departments in the municipality of Campinas is inadequate and poorly scaled, jeopardizing the treatment of poisoned patients / Mestrado / Saude da Criança e do Adolescente / Mestra em Ciências

This thesis first briefly mentions the characteristics of the skin and contains a review of current knowledge on the in vitro permeation testing of drugs through the skin. It describes the basic data about nerve agents and the possibilities of prophylaxis poisoning warfare agents focusing on preventive transdermal administration. The experimental work is focused on in vitro testing abilities oxime HI-6 and posibly other reactivators enzyme acetylcholinesterase penetrate through pig skin. Experiments were conducted in static diffusion cells Franz type. The amount of test substance leaked through the skin is determined in the sample of receptor fluid by HPLC. Keywords permeation in vitro; transdermal; pig skin; Franz cell; substance HI-6; antidota; nerve agents; acetylcholinesterase

The activity of mitochondrial cytochrome c oxidase (COX) can be affected by either exogenous or endogenous factors. The most efficient and in the environment abundant compound that inhibits COX is cyanide. The very frequent cause of COX deficiency in humans is represented by a defect in the SURF1 gene. The mechanism of cyanide inhibitory effect on COX as well as the conditions for its recovery are not yet fully explained. Three parameters of COX function, namely the transport of electrons (oxygen consumption), the transport of protons (mitochondrial membrane potential, m) and the enzyme affinity to oxygen (p50 value), were studied with regard to the inhibition by KCN and its reversal by pyruvate. The function of COX was analysed in intact isolated rat liver mitochondria, both within the respiratory chain and as a sole enzyme, using succinate or an artificial electron donor ascorbate + TMPD as a substrate. 250 M KCN completely inhibited both electron- and proton-transporting function of COX, and this inhibition was reversible as proved with washing of mitochondria. The addition of 60 mM pyruvate induced the maximal recovery of both parameters to 60 - 80 % of original values. Using KCN in the low concentration range up to 5 M, a profound, 30-fold decrease of COX affinity to oxygen was observed....