How Pb Protects against Soman Exposure

Pyridostigmine bromide (PB) is a drug, often given as a tablet, that has been approved since 1955 by the U.S. Food and Drug Administration for treatment of myasthenia gravis, a disease characterized by weakness and fatigability of the muscles. During the Persian Gulf War (PGW), PB was used as an “investigational new drug” (IND) by the U.S. military and some other allied forces as a pretreatment adjunct to protect military personnel from death in event of attack with the nerve agent soman. (IND status conferred by the FDA does not permit unrestricted use but may, as in this case, have conditions attached.) PB is called a pretreatment adjunct because it must be given before exposure to be effective. Also, it is not effective alone but only confers benefit if postexposure treatments are given as well.