War gases mainly include chemicals widely used in warfare against enemy. this presentation is about classification of war gases, mechansm of action & treatment to some extent.

1. Dr Ashutosh B. Potdar,
Prof & Head,
Dept of Forensic Medicine,
D.Y. Patil Medical College, Kolhapur

2. 2013
•The Syrian military
used sarin gas against
civilians during the
Syrian Civil War; killed more than 1300
•Bashar al-Assad’s government
relinquishes its arsenal of chemical
weapons after threats of U.S. air strikes

3. War gases
•War gases: agents used to kill, injure or
incapacitate enemies
•In civil conditions: to disperse the unruly mob
•First World War: more than 100,000 people
died and about 1.2 million affected due to
use of chlorine, phosgene, and nitrogen
mustard

4. War gases
•Second World War: Germans developed
and used number of nerve agents (tabun,
sarin and soman together referred as “G”
military agents)
•English developed
•VX in 1952

5. Qualities of IdealWar Gas
•Capable of being manufactured cheaply in
enormous quantities as any industrial
byproduct
•Highly toxic in low concentration
•Heavier than air

6. Qualities of IdealWar Gas
•Capable of enough
volatilization pervading
assailed area
•Gas should not corrode
the containers used for
storages

7. Classification
•Lacrimators
•Lung irritants
•Vesicants
•Sternutators
•Paralysants
•Nerve gases

8. Lacrimators
•These are tear gases and cause tearing
of eyes
•E.g. Chloracetophenon (CAP)
•Bromobenzyl cyanide (BBC)
•Ethyl-iodo-acetate (KSK)

9. Lacrimators
•Fired during an attack on mob in the artillery
shells or pen guns, so as to saturate the area of
attack

10. Lacrimators
•Chloroacetophenone (CAP): a solid, in a finely
divided powder form, locust flower odour and
disintegrates rapidly
•Bromobenzyl cyanide (BBC): heavy oily dark
brown liquid with fruity odour. Its effect may
persist for a maximum of 3 days
•Ethyliodoacetate (KSK) is also heavy oily liquid,
with its effect persisting for 10 days

11. Action
•Intense irritation of eye
and profuse lacrimation
•Spasm of eyelids
•Nausea and vomiting
•Irritation of air passage
and sore throat
•Rhinorrhea, Cough
•Prolonged exposure leads
to blistering of skin,
conjunctivitis, corneal
ulceration, keratitis, and
pneumonitis
•In rare case, they may
cause acute
laryngotracheobronchitis
or death.

12. Treatment
•Shift the patient to fresh air
•Eye care: irrigate/ wash the eyes with
normal saline or boric acid solution
•Skin, nose and other site: apply weak
solution of sodium bicarbonate

13. Lung irritants
•These are asphyxiants or choking agents
•E.g.: Chlorine
•Phosgene
•Diphosgene
•Chloropicrin

14. Lung irritants
•Chlorine (Cl2) and phosgene (COCl2), are gases,
but are hot liquid under pressure
•Chloropicrin, diphosgene are liquids
• All these are used in shells
•Phosgene is ten times and chloropicrin is four
times more toxic than chlorine
•Phosgene and diphosgene are called ‘green
cross.’

15. Action
•Mainly act on the alveoli
•Dyspnoea, tightness in the chest, cough, irritation of
conjunctivae followed by
•Restlessness, rapid and stertorous respiration
(breathing having a heavy snoring sound)
•Cyanosis, followed by collapse and death due to
acute pulmonary edema

16. Treatment
•Shift to clean atmosphere
•Give oxygen and adrenaline
•Eyes: irrigation/ washing with normal saline/
boric acid
•Symptomatic measures (e.g. codeine for
cough, and antibiotics for respiratory
tract/lung infection)

17. Vesicants (Blister Gases)
•Agents that cause blisters
1. Mustard gas (dichloroethyl sulphide,
yellow cross, yperite, etc.)
2. Lewisite
•Both are liquid form
•Fired during an attack in the artillery shells so
as to saturate the area of attack

18. Clinical features
•Produce severe irritation of eyes, nose,
throat, and respiratory passages
•Severe irritation of the skin especially
over the oily areas, such as face, axillae,
pubis, scrotum
•Redness, vescication/blister formation (of
varying size)

19. Clinical features
•Ulceration especially over the moist areas
•Intense itching of the skin
•Nausea, vomiting, pain abdomen,
diarrhoea, etc
•Rarely death due to bronchopneumonia

20. Treatment
•Remove contaminated clothing worn and
wash the body with soap and water
•Solution of sodium bicarbonate for
irrigation of eyes (2%) and nose (5%)
•BAL is antidote for lewisite

21. Sternutators (Nasal Irritants,
Vomiting Gases)
•These are nasal irritants
•E.g.: Diphenylamine chlorarsine (DM)
•Diphenyl chlorarsine (DA)
•Diphenyl cyanarsine (DC)
•Diphenyl chlorarsine is six times heavier
than air

22. Sternutators (Nasal Irritants,
Vomiting Gases)
•Diphenyl chlorarsine  the vomiting centre
•Intense pain and irritation in nose and
sinuses leading to sneezing, malaise, and
headache
•Salivation followed by nausea, vomiting and
chest pain
•Symptoms of arsenic poisoning

23. Treatment
•Remove contaminated clothing worn
•Solution of sodium bicarbonate for
irrigation of eyes (2%) and nose (5%)

24. Nerve Gases
•These agents have acetylcholine like
action.
•E.g: Tabun
•Sarin
•Soman
•VX

25. Nerve Gases
•Compounds of phosphate esters in action
and toxicity
•Colourless and odourless volatile liquids
•Absorbed from lungs, gastrointestinal
tract, skin and conjunctivae
•Sarin and tabun, Soman, VX

26. •Act mainly by inhibiting cholinesterase at
cholinergic synapses
•Consequent accumulation of acetylcholine
results in muscle twitching, glandular
hypersecretion and cognitive and mood effects
•High doses cause seizures and death from
respiratory failure
•Nerve agents affect both main types of
cholinergic receptor—muscarinic and nicotinic

27. Clinical features
•Pinpoint pupil
•Rhinorrhoea, bronchial spasms
•Ciliary spasm: pain in eyeballs leading to
photophobia
•Sudden unconsciousness and bradycardia
•Respiratory arrest and death

28. Treatment
•An oxime is given to detach the agent
from cholinesterase, thus reactivating the
enzyme
•Mitigates both nicotinic and muscarinic
effects, for those nerve agents against
which oximes are effective

29. Treatment
•Muscarinic antagonist atropine is used to
quell the effects of excessive
acetylcholine action
•Atropine is of special value when the
nerve agent is oxime-resistant (soman) or
when symptoms are severe

30. Thank You