TABLE 8-4Potential Antidotes for Pulmonary Phosgene

AntidoteEfficacyAvailabilityPotential Civilian UtilityStockpile
Hexamethylene tetraminea (methenamine; urotropin, HMT)Limited prophylactic effect; no convincing benefit after exposureYesNoneN/A
Cysteineb,cTraps phosgene and converts to less harmful metabolites.YesInsufficient evidenceHospital emergency dept.
N-acetylcysteinedEvidence in rabbits onlyYesPrehospital?
Pre- and post-exposure		Hospital emergency dept.
CorticosteroidseTo decrease inflammation Limited evidenceYesYesHospital emergency dept.
AminophyllinefPreexposure and postexposure
Attenuates lipid peroxidation		YesYesHospital emergency dept.
a

Diller, 1980; bBridgeman et al., 1991; cLailey et al., 1991; dScuito et al., 1995; eLorin and Kulling, 1986; fSciuto et al., 1997.

From: 8, Availability, Safety, and Efficacy of Drugs and Other Therapies

Cover of Chemical and Biological Terrorism
Chemical and Biological Terrorism: Research and Development to Improve Civilian Medical Response.
Institute of Medicine (US) Committee on R&D Needs for Improving Civilian Medical Response to Chemical and Biological Terrorism Incidents.
Washington (DC): National Academies Press (US); 1999.
Copyright 1999 by the National Academy of Sciences. All rights reserved.

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