Sarin (GB, O-isopropyl methylphosphonofluoridate) is a potent organophosphorus (OP) nerve agent that

inhibits acetylcholinesterase (AChE) irreversibly. Accumulation of acetylcholine (Ach) at peripheral

autonomic synapses leads to peripheral signs of intoxication and overstimulation of the muscarinic and
nicotinic receptors, which is described as “cholinergic crisis” (i.e. diarrhea, sweating, salivation, miosis,
and bronchoconstriction). Exposure to high doses of sarin can result in tremors, seizures, and
hypothermia. A more severe effect of sarin is the build-up of ACh in the central nervous system (CNS)
which causes paralysis and ultimately peripherally-mediated respiratory arrest, leading to death.
 
 
Sarin is generally considered a weapon of mass destruction. It was used during the morning rush hour
on March 20, 1995 in a terrorist attack on commuter subway trains in Tokyo, Japan. This was
discovered by a German scientist who was attempting to create stronger pesticides. It is a nerve agent
classified by an intergovernmental military alliance called NATO as G-series “B” named after the
German scientists who first synthesized them.
 
It is a potent organophosphorus nerve agent that inhibits acetylcholinesterase irreversibly which
acetylcholinesterase is an enzyme that degrades the acetylcholine after it is released into the
synaptic cleft. This results  in an increased amount of neurotransmitter called acetylcholine leading to
death by asphyxiation due to inability to control the muscles involved in breathing.
 
Exposure to high doses of sarin can result in tremors, seizures and hypothermia.
 
The subsequent build-up of acetylcholine in the central nervous system provokes seizures and,
at sufficient doses, centrally-mediated respiratory arrest
 
 
Accumulation of ACh at peripheral autonomic synapses leads to peripheral signs of intoxication and
overstimulation of the muscarinic and nicotinic receptors, which is described as “cholinergic crisis” (i.e.
diarrhea, sweating, salivation, miosis, bronchoconstriction)
 

sarin is lethal to 50 percent of exposed individuals at doses of 100 to 500 mg across the skin, or
50–100 mg/min/m3 by inhalation

Sarin is a member of a class of chemicals known as organophosphorus esters

Gulf War and Health: Volume 1

Pyridostigmine bromide (carbamates class)

Pyridostigmine is used to improve muscle strength in patients with a certain muscle
disease (myasthenia gravis). It works by preventing the breakdown of a certain
natural substance (acetylcholine) in your body. Acetylcholine is needed for normal
muscle function.
Organophosphates are phosphoric acid esters or thiophosphoric acid esters

Carbamates are esters of N-methyl carbamic acid.

Medical management of the acute cholinergic syndrome includes mechanical ventilation and the
administration of several medications (anticholinergics, anticonvulsants, and drugs that break the
chemical bond between sarin and AChE)

A high level of sarin exposure of humans (after single or multiple exposures) is presumed to
have occurred when the acute cholinergic syndrome is manifest. An intermediate-level exposure
is presumed to have occurred when the acute cholinergic effect is limited to miosis (contraction
of the pupil), rhinorrhea (an extreme type of runny nose), and depressed cholinesterase levels in
the blood. Finally, low-level exposure may have occurred even though there are no immediately
detectable cholinergic signs and symptoms