This special publication provides technical information on pyridostigmine bromide (PB) to health care professionals of the Army, Navy, Air Force and allied nations on the topic of chemical casualty care, in accordance with the postgraduate medical education mission of the Institute. The information is doctrinally consistent and assumes a working knowledge of the tri-service field manual "Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries," Army FM 8-285, Navy NAVMED P-5041, Air Force AFM 16011, dated February 1990. The currently fielded pretreatment for nerve-agent exposure is PB. Military physicians and other health-care providers need to be familiar with this medication, with the rationale for its use, and with its effects on the body. They also need to be able to respond intelligently to questions from users of PB, patients, and field commanders. This publication is intended to address the major issues that military health-care providers need to understand concerning nerve-agent pretreatment with PB. It is organized around a series of questions about PB in general and its pharmacokinetics (absorption, distribution, biotransformation, and elimination), pharmacodynamics (mechanism of action), field use, and reported and expected effects.
USAMRICD Special Publication 98-01