title: Evaluation of a two-drug combination pretreatment against organophosphorus exposure.
abstract: A pretreatment combination of physostigmine and azaprophen (6-methyl-6-azabicyclo[3.2.1]octan-3-ol-2,2-diphenylpropionate), a novel cholinolytic, was evaluated for its ability to minimize soman-induced incapacitation and lethality in guinea pigs. This was accomplished by using response surface methodology to model and analyze the combination, varying physostigmine from 0 to 194 micrograms/kg, azaprophen from 0 to 5 mg/kg, and soman from 30 to 150 micrograms/kg. One hundred percent survival was achieved against 5 LD50 of soman using as little as 100 micrograms/kg of physostigmine in the presence of 5 mg/kg azaprophen. Both survival and soman-induced incapacitation were similarly affected by this pretreatment combination. For both endpoints, greater efficacy was achieved with the combination than could be achieved with either component alone (therapeutic synergism). This suggests that such a pretreatment combination may prove very efficacious against soman-induced lethality and incapacitation in higher species.
authors.affiliation: U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland 21010-5425.
authors.forename: R P
authors.initials: RP
authors.lastname: Solana
authors.forename: L W
authors.initials: LW
authors.lastname: Harris
authors.forename: W H
authors.initials: WH
authors.lastname: Carter
authors.forename: B G
authors.initials: BG
authors.lastname: Talbot
authors.forename: R A
authors.initials: RA
authors.lastname: Carchman
authors.forename: C
authors.initials: C
authors.lastname: Gennings
mesh_terms: D000818:Animals; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004912:Erythrocytes / Q000187:drug effects / Q000201:enzymology; D005260:Female; D006168:Guinea Pigs; D007928:Lethal Dose 50; D008297:Male; D010666:Phenylpropionates / Q000008:administration & dosage*; D010830:Physostigmine / Q000008:administration & dosage*; D012999:Soman / Q000037:antagonists & inhibitors / Q000633:toxicity*; D014326:Tropanes / Q000008:administration & dosage*
chemical_list: D002800:Cholinesterase Inhibitors; D010666:Phenylpropionates; D014326:Tropanes; C052339:azaprophen; D012999:Soman; D010830:Physostigmine