失能性毒劑-課件

Chapter5

Incapacitatingagents失能性毒劑1ppt課件2ppt課件失能性毒劑簡(jiǎn)稱失能劑，是一類暫時(shí)使人員喪失戰(zhàn)斗能力的化學(xué)戰(zhàn)劑。中毒后主要引起精神活動(dòng)異常和軀體功能障礙，一般不引起永久性或致死性傷害。1.Overview3ppt課件呼吸道吸入，作用強(qiáng)；改變中樞神經(jīng)系統(tǒng)的調(diào)節(jié)功能或促使神經(jīng)生理功能失調(diào)；有較大的安全比；作用時(shí)間持續(xù)數(shù)小時(shí)至數(shù)天；理化性質(zhì)穩(wěn)定，能大量生產(chǎn)，價(jià)格低廉。作為失能劑的條件安全比4ppt課件用途戰(zhàn)場(chǎng)上支援雙方混雜而又不知己方確切位置的軍隊(duì)搶救戰(zhàn)俘或俘虜對(duì)方人員以獲取情報(bào)間諜活動(dòng)平時(shí)轉(zhuǎn)為警用，用于反恐5ppt課件

16世紀(jì)的“牛角”→麥角菌→麥角酸南美仙人掌的芽亞馬遜河流域的毒蘑菇俄羅斯和我國(guó)西藏地區(qū)的毒蠅菌野荔枝的果仁變質(zhì)糧食作物致幻植物6ppt課件hallucinogenicplantsΔ9-tetrahydrocannabinol(THC),analgesiceffectsCannabisPsychoactivecactiCannabissativa

Echinopsispachanoi,usedforhealingandreligiousdivinationintheAndesMountainsregionforover3000years,SaintPetercactus,"toreachheavenwhilestillonearth."mescalineLophophorawilliamsii

7ppt課件Psychoactivemushrooms--psilocybinmushrooms

PsilocybesemilanceataPsilocybesubaeruginascensPsilocybecyanofriscosapsilocybinpsilocinMayan"mushroomstones"ofGuatemalaserotonin8ppt課件Theuseofchemicalstoinducealteredstatesofminddatestoantiquityandincludestheuseofplantssuchasthornapple(Daturastramonium,曼陀羅)thatcontaincombinationsofanticholinergicalkaloids.History/MilitaryRelevance9ppt課件600BC:Solon

helloborerootsthrowintoriverdiarrhea200BC:CarthaginiansMandragora-lacedwinenarcosisMandragoraofficinarum(毒參茄,風(fēng)茄)10ppt課件184BC:Hannibal

belladonnaalkaloidsdisorientation

1500sand1600s:Moslems

Harnish(以印度大麻提煉的麻藥)usedonowntroopstofosterfearlessness1908:200Frenchsoldiers

poisonedwithHyoscyamusfalezlezdeliriousandhallucinationsinHanoi11ppt課件2.Representatives:

BZLSD12ppt課件失能劑的分類與主要代表葡萄球菌腸毒素B產(chǎn)生嘔吐EA1476、ADL226169降低血壓麥沃卡因肌肉松弛苯咪胺、優(yōu)托芬引起癱瘓軀體失能劑麥角酰二乙胺(LSD)、西洛賽賓、麥司卡林中樞興奮畢茲(BZ)、四氫大麻醇(THC)、氟菲那嗪、氟哌啶醇中樞抑制精神失能劑失能劑代表主要作用特點(diǎn)分類13ppt課件精神失能劑(psychicincapacitatingagents)：中毒后可引起精神錯(cuò)亂，知覺、情感和思維活動(dòng)的障礙。14ppt課件中樞抑制劑(central

nervoussystemdepressant)：能降低或阻斷中樞神經(jīng)系統(tǒng)的活動(dòng)，干擾突觸間的信息傳遞。15ppt課件中樞興奮劑(centralnervoussystemstimulant)：可使那些原來不易通過某些突觸的神經(jīng)沖動(dòng)容易傳導(dǎo)過去，致使過多的信號(hào)“涌進(jìn)”了皮層和其他高級(jí)中樞。16ppt課件軀體失能劑(Somaticincapacitatingagents)

：是指暫時(shí)地破壞身體某方面正常功能的化合物，如引起癱瘓、直立性低血壓、體溫調(diào)節(jié)障礙、嘔吐、失明、震顫等癥狀，使人員暫時(shí)失去或降低戰(zhàn)斗力。17ppt課件ListofChemicalWarfareAgents(fromSIPRI):

IncapacitatingagentsDepressantsMorphinePsychedelicdrugsAgent-15BZLysergicacid-25MescalinePhenylcyclidinePsilocybinStimulantsAmphetamineCocaineDexamphetamineMethamphetamineSIPRI:StockholmInternationalPeaceResearchInstitute18ppt課件StructureofBZ(3-quinuclidinylbenzilate)3.Physicochemicalcharacteristics

19ppt課件白色或微黃色粉末(熔點(diǎn)165-166C，沸點(diǎn)>300C)，無特殊氣味，不溶于水，與HCl等作用生成鹽易溶于水。遇熱較穩(wěn)定：毒煙罐。水解很慢，可造成水源長(zhǎng)期染毒。染毒水需經(jīng)蒸餾—吸附劑處理后才能飲用。揮發(fā)度小，加熱加壓加堿(三加）方可加速破壞。20ppt課件Usuallybeusedinthebattlefieldintheformoftoxicsmokeviaevaporationoraerosolviaexplosion

(加熱蒸發(fā)法產(chǎn)生毒煙或爆炸成氣溶膠吸入中毒).Expensive,difficultyinproduction.Unevenscatteringinthebattlefield

(野戰(zhàn)條件播散不均勻).TacticpropertiesofBZ21ppt課件4.Toxicity

ICt50forBZis112mg·min/m3

LCt50is200,000mg·min/m3(estimated).Thecharacteristicisitshighsafetyratio(LCt50/ICt50).

22ppt課件

Theamountrequiredtoproduceeffectsisathousandormorefoldlessthanafataldoseofthecompound.

BZaffectsyourabilitytoremember,solveproblems,payattention,andunderstandinstructions.

Manynewsnetworksspeculated:BZusedbyRussiatodisabletheChechengunmenthatseizedtheMoscowtheateronOctober23,2002.23ppt課件Terroristsallkilledorcaptured;750hostagesrescued129hostagesdied(2diefromgunshot).24ppt課件5.DistributionFollowingabsorption,systemicallydistributedtomostorgansandtissues.AbilitytoreachsynapsesandneuromuscularandneuroglandularjunctionsthroughoutthebodyisresponsibleforitsPNSeffects.Abilitytocrosstheblood-brainbarrier(BBB)isresponsibleforCNSeffects.25ppt課件6.Mechanismoftoxicity

BZisananticholinergicglycolateactingascompetitiveinhibitoroftheneurotransmitteracetylcholineatpostjunctionalmuscarinicreceptorsincardiacandsmoothmuscleandinexocrineglandsatpostsynapticreceptorsinneurons

26ppt課件畢茲中毒原理BZ膽堿能受體(M)阻斷乙酰膽堿與受體結(jié)合阻斷中樞M樣受體阻斷周圍M樣受體中樞M系統(tǒng)機(jī)能抑制思維感覺混亂、運(yùn)動(dòng)障礙周圍膽堿能M機(jī)能下降阿托品樣作用主要方面次要方面思維：輕－嗜睡、中+重－幻覺、譫妄運(yùn)動(dòng)：條件反射和行為活動(dòng)改變簡(jiǎn)單計(jì)算失能(加減法)27ppt課件Nervetransmission:nervetosmoothmuscle28ppt課件BZBZBZBZBZBZBZBZBZBZBZActionofBZandatropineonsmoothmuscleACh29ppt課件Nervetransmission:nervetoexocrineglandACh30ppt課件BZBZBZBZBZBZBZBZBZBZAction

of

BZandAtropine

on

exocrine

glandsACh31ppt課件7.ClinicaleffectsPeripheralEffects

Mydriasis(瞳孔散大),blurredvision:"blindasabat"

Drymouth(xerostomia),skin,anddecreasedsecretionsfromlacrimaletal.:"dryasabone"

Warmskin:"hotasahare"Initiallyrapidheartrate;later,normalorslowheartratePossibleatropineflush:"redasabeet"32ppt課件CentralEffects:33ppt課件DisturbancesinlevelofconsciousnessMisperceptionsanddifficultyininterpretation(delusions,hallucinations)Poorjudgementandinsight(denialofillness)Shortattentionspan,distractibility,impairedmemory(particularlyrecent)Slurredspeech,perseverationDisorientationAtaxia(共濟(jì)失調(diào))

Variability(quiet/restless)CentralEffects:"madasahatter"

34ppt課件分期時(shí)間(h)周圍癥狀中樞癥狀運(yùn)動(dòng)思維、感覺潛伏期0.5~1——————發(fā)展期1~4視力模糊、口干、惡心嘔吐、顏面潮紅、心跳加快、體溫升高、尿潴留無力，動(dòng)作不穩(wěn)、言語不清、安靜少動(dòng)、木僵眩暈、嗜睡、思維混亂、幻覺高峰期4~12同上不能活動(dòng)譫妄狀態(tài)，對(duì)周圍環(huán)境無有效反應(yīng)恢復(fù)期12~16同上，減輕活動(dòng)增多有盲目行動(dòng)BZ中毒的主要癥狀及臨床分期35ppt課件某科研單位的新戰(zhàn)士發(fā)生BZ重度中毒。10min口干、頭痛，30min神志不清、躁動(dòng)、散瞳、顏面潮紅、咬人，9h達(dá)高峰，T40.8℃，P142次/分；經(jīng)抗毒治療24h后安靜，幻覺消失，神志清醒，下床與戰(zhàn)友談笑，但仍無力。36ppt課件Sharingofillusionsandhallucinations:e.g.masshysteria

SimilaritytopsychogenicconditionsMayprovehazardous

Psycosocialaspects37ppt課件8.DiagnosisanddifferentialdiagnosisExposurehistoryBZ’sspecificclinicalcluesarethecombinationofanticholinergicPNSeffects("dryasabone,""hotasahare,""redasabeet,"and"blindasabat")withtheCNSeffects("madasahatter")CheckAChEactivitytobedistinguishedwithnerveagents38ppt課件俄當(dāng)局最初拒絕透露使用了何種化學(xué)劑。DoyouthinkitisBZ?OPCW要求后，俄衛(wèi)生部聲稱，是一種氣溶膠化的芬太尼類制劑(Kolokol-1,為強(qiáng)力鎮(zhèn)靜劑),

并聲稱未違反《禁止化學(xué)武器公約》。關(guān)于莫斯科人質(zhì)事件中所用氣體

39ppt課件畢茲中毒預(yù)防防毒面具有很好的防護(hù)效果，在沒有面具時(shí)，簡(jiǎn)易防護(hù)措施也有一定的效果。40ppt課件9.MedicalManagement

Generalsupportivemanagement

Antidotes

Symptomaticmanagement

Intensivenursing41ppt課件由于行為無常導(dǎo)致的自傷與誤傷高熱（Hyperthermia）嚴(yán)重的心律失常及電解質(zhì)紊亂最大的危險(xiǎn)來自于42ppt課件Specificantidote:毒扁豆堿,解畢靈,催醒安Physostigmine毒扁豆堿解畢靈催醒安43ppt課件－－－200-300mg

催醒安5-7.5mg/3-4hr

5-10mg

60min

10-20mg

解畢靈1-2mgim/1-2hr2-4mgpo/1-2hr

2-4mg

40min

2-4mg

毒扁豆堿維持量重復(fù)量間隔時(shí)間首量藥物觀察療效評(píng)價(jià)標(biāo)準(zhǔn)：心率逐漸減慢至70~80次/分；意識(shí)逐漸清楚；計(jì)算有進(jìn)步；外周癥狀消失。BZ抗毒劑及使用方法44ppt課件Physostigmine:acarbamate,possessanticholineraseactivityRaiseAChconcentrations

temporarilybybindingreversiblytoAchEonthepostsynapticorpostjunctionalmembrane.Similartopyridostigmineandequallyeffectivewhenusedasapre-exposureantidotalenhancer(“pretreatment”)forsoman(sideeffects).Nonpolarcomp.,canpenetrateintothebrain;pyridostigminecannot(quaternaryammoniumsalt),sonotforBZ.

45ppt課件pyridostigmineneostigmine46ppt課件Testdose:1mg,routinedosinggivenifaslightimprovementoccurs.Routesofadministration:IM:45g/kginadults(20g/kginchildren)IV:30g/kgslowly(1mg/min)PO:60g/kgifpatientiscooperative(becauseofbittertaste,considerdilutinginjuice)Foreachroute,titrateperhourtomentalstatus.Doseandtimeintervalofdosingmodifiedaccordingly;withimprovements,decreasingdosage.Physostigmineisasafeandeffectiveantidoteifusedproperly(shouldbeundercarefulsurveillance).

Suggesteddosagesinthetreatment:47ppt課件監(jiān)督給藥，隨時(shí)觀察療效及毒性反應(yīng)。出現(xiàn)汗多、腹痛、嘔吐、肌顫等毒性反應(yīng)可減量或延長(zhǎng)給藥時(shí)間。心律不齊、收縮壓低于90mmHg、脈搏少于60次/分，應(yīng)暫停給藥。心率減慢、嘔吐，可給阿托品0.5mg肌注。巴比妥類藥物禁用。用藥注意事項(xiàng)48ppt課件對(duì)癥處理：高熱(處理不及時(shí)可致呼吸、循環(huán)衰竭而死亡)：物理降溫，注意糾正酸中毒、缺O(jiān)2，防止腦水腫。極度煩躁、躁動(dòng)：常因抗毒劑用量不足或膀胱過度充盈所致，可采用導(dǎo)尿或給小劑量安定劑氯丙嗪。散瞳、視力模糊：0.25%毒扁豆堿或1%毛果蕓香堿滴眼。尿潴留：新斯的明0.5~1mg或毛果蕓香堿5~10mg肌注。心動(dòng)過速：腎上腺素-受體阻斷劑心得安。昏迷：加強(qiáng)護(hù)理。49ppt課件加強(qiáng)護(hù)理：防中暑限制飲水防止自傷或誤傷50ppt課件51ppt課件52ppt課件53ppt課件5－羥色胺LSD麥角酰二乙胺54ppt課件LSD中毒一種毒性很高的麥角生物堿，性質(zhì)穩(wěn)定，不溶于水，受熱易分解，但作用強(qiáng)，安全比值大。結(jié)構(gòu)與5-HT相似，能與5-HT受體結(jié)合，阻斷和減弱了5-HT的作用，擾亂了皮層、下丘腦和網(wǎng)狀結(jié)構(gòu)的正常生理