M1 macrophages are pro-inflammatory and produce cytokines such as IL-1, IL-6, IL-12, and TNF-
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a few drops can be lethal Synthesized as a chemical weapon in 1952 Estimated LC t 50 by inhalation: 10 mg-min/m Percutaneous LD 50 : 6-10 mg Novichok Extremely toxic nerve agent developed in the Soviet Union during the 1970s and 1980s A series of different agents with cholinergic effects Irreversibly binds to acetylcholinesterase, preventing acetylcholine breakdown Binary chemical weapon Considered the most deadly nerve agent, more lethal than VX and Soman Cannot be detected by traditional NATO chemical detection methods Penetrates older NATO hazmat suits Easy to transport, difficult to manufacture and detect Can be inhaled, injected, absorbed through the skin, or ingested Neurological symptoms: hallucinations, slurred speech, muscle fasciculations, muscle cramps, paralysis, seizures Miosis (pupil constriction) Respiratory symptoms: salivation, coughing, bronchospasm, bronchorrhea Cardiac symptoms: bradycardia, conduction disturbances, cardiac arrest Electrolyte imbalances: hyperglycemia, hypokalemia Diagnostics Measure acetylcholinesterase activity (cholinesterase activity in plasma) Treatment Decontamination before hospital admission
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