Laboratory Diagnosis of Organophosphates/Nerve Agent Poisoning

Organophosphorus inhibitors of cholinesterases (commonly called organophosphates, OP) are used in industry as softening agents, hydraulic liquids, lubricant additives, plasticizers, antioxidants, and for antiflammable modifications. They are also used in veterinary or human medicine as drugs or chemicals for the study of nervous functions. They differ in their toxicity from practically non-toxic chemicals (malathion) to highly toxic agents such as sarin, soman, VX and other nerve agents known as the most important group of chemical warfare agents (1–9). Nerve agents were also used by terrorists in 1994 and 1995 in Japan (10, 11). Therefore, the mechanism of action, diagnosis and treatment of intoxications with OP and nerve agents is a very actual at present. Some principles of the effects, diagnosis and therapy are very similar for OP and highly toxic nerve agents and, therefore, the principles described in this article can be applied in general for both groups – OP and nerve agents. OP includes a large variety of compounds with different physical chemical and biological properties including toxicity. OP are liquids of different volatility, soluble or insoluble in water, organic solvents etc. The most important group having a significant biological effect include compounds of the general formula