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Incapacitating Agents (BZ, Agent 15)

Incapacitating Agents (BZ, Agent 15)

Diagnosis

1.
3-quinuclidinyl benzilate (BZ)

2.
Mydriasis, dry mouth, dry skin

3.
Incr’d DTRs; decr’d LOC; confusion; disorientation

4.
Illusions and/or hallucinations; denial of illness; short attention span; impaired memory

5.
Stage 1 (0-4 hrs): parasympathetic blockade and mild CNS effects

6.
Stage 2 (4-20 hrs): stupor with ataxia and hyperthermia

7.
Stage 3 (20-96 hrs): full-blown delirium

8.
Stage 4: paranoia, deep sleep, reawakening, crawling, climbing automatisms, eventual reorientation
History

1.
In 600 BC Solon’s soldiers threw hellebore roots to contaminate enemy water supply

2.
In 184 BC Hannibal’s army used belladonna plants to induce disorientation

3.
Bishop of Muenster in AD 1672 used belladonna in assault on Groningen

4.
In 1908, 200 French soldiers in Hanoi became delirious and experienced hallucinations after being poisoned

5.
After WWII, US investigated wide range of possible nonlethal, psychobehavioral, chemical incapacitating agents including psychedelic indoles e.g. lysergic acid diethylamide (LSD-25), marijuana derivatives

6.
3-quinuclidinyl benzilate, assigned NATO code BZ, weaponized in 1960’s

7.
In 1998, Iraq accused of stockpiling large amounts of glycolate anticholinergic incapacitating agent: Agent 15
Pathophysiology

1.
BZ is glycolated anticholinergic related to atropine, scopolamine, hyoscyamine

2.
Competitive inhibitor of acetylcholine

3.
Half-life of 3-4 wks in moist air; even heat-producing munitions can disperse it

4.
Persistent in soil and water; soluble in propylene glycol, DMSO

5.
ICt is 112 mg-min/m3

6.
Duration 72-96 hrs
Decontamination

1.
Flush skin and hair with soap and water

2.
Remove clothing
Treatment

1.
Antidote: physostigmine IM: 45 mcg/kg; IV: 30 mcg/kg slowly (1 mg/min); PO: 60 mcg/kg if patient cooperative (dilute in juice); titrate q60 mins to mental status

2.
Support, IVF

3.
Observation

4.
Physical restraints
Disposition

1.
Admit

2.
Notify CDC & local health dept
Military Detection/Treatment Kits
(See Chemical Agent ID/Detection)

1.
No field detector available

* Material is taken from the PEPID database
* Copyrighted material – All Rights Reserved
* For more information visit http://www.pepid.com

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