The efficacy of a combinational prophylactic regimen on the lethality, convulsions, and loss of morphological and functional integrities of the brain induced by an
organophosphate soman was investigated in rats. The rats were implanted subcutaneously with osmotic minipumps containing the combinational prophylactic regimen composed of
physostigmine, a reversible
cholinesterase inhibitor, and
procyclidine, an
N-methyl-D-aspartate antagonist possessing
anticholinergic action, for 3 days, and intoxicated subcutaneously with
soman (160 microg/kg, 1.3 LD50). The doses of combinational regimen in minipumps were optimized to achieve 30-35% inhibition of blood
cholinesterase activity by
physostigmine and 50-100 ng/ml of blood concentrations of
procyclidine as clinically available doses, respectively. In comparison, 1-[([4-(aminocarbonyl)pyridinio]methoxy)methyl]-2-[(hydroxyimino)methyl]pyridinium (
HI-6, 125 mg/kg) was administered intraperitoneally 30 min prior to the
soman challenge in control groups to reduce mortality of rats without affecting convulsions.
Soman induced profound limbic convulsions and 30% mortality, leading to increased blood-brain barrier permeability, neural
injuries, learning and memory impairments, and physical incapacitation of survived rats pretreated with
HI-6. The combinational regimen, at optimal doses without adverse effects on passive avoidance performances (72 microg/kg/h of
physostigmine plus 432 microg/kg/h of
procyclidine), exerted full protective effects against lethality, convulsions, blood-brain barrier opening,
brain injuries, learning and memory impairments, and physical incapacitation induced by
soman. Taken together, it is suggested that the combination of
physostigmine and
procyclidine, at adequate doses, could be a choice to provide the victims of
organophosphate poisoning with chance of
intensive care for survival and neuroprotection.