Bz

Bz
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Delirium, hallucinations, dry mouth, tachycardia
Complications	Seizures, coma
Onset	Within 1-4 hours of exposure
Duration	72-96 hours
Types	N/A
Causes	Exposure to 3-Quinuclidinyl benzilate
Risks	Military and chemical warfare exposure
Diagnosis	N/A
Differential diagnosis	N/A
Prevention	Avoidance of exposure
Treatment	Supportive care, benzodiazepines
Medication	N/A
Prognosis	N/A
Frequency	N/A
Deaths	N/A

Bz, also known as 3-Quinuclidinyl benzilate, is a potent anticholinergic compound that has been used as a chemical warfare agent. It is classified as an incapacitating agent due to its ability to cause delirium and hallucinations without causing permanent harm or death in most cases.

Chemical Properties

Bz is a synthetic anticholinergic compound with the chemical formula C₂₁H₂₃NO₃. It is a white crystalline powder that is odorless and tasteless. Bz is lipophilic, allowing it to cross the blood-brain barrier and exert its effects on the central nervous system.

Mechanism of Action

Bz acts as a competitive antagonist at muscarinic acetylcholine receptors, particularly the M1 receptor subtype. By blocking these receptors, Bz inhibits the action of acetylcholine, a neurotransmitter involved in cognitive function, memory, and muscle contraction. This leads to the characteristic anticholinergic syndrome associated with Bz exposure.

Clinical Presentation

The symptoms of Bz exposure typically begin within 1 to 4 hours and can last for 72 to 96 hours. The clinical presentation includes:

• Delirium
• Hallucinations
• Dry mouth
• Tachycardia
• Mydriasis (dilated pupils)
• Urinary retention
• Hyperthermia

In severe cases, complications such as seizures and coma may occur.

Diagnosis

Diagnosis of Bz exposure is primarily clinical, based on the characteristic symptoms and history of potential exposure. Laboratory tests may show elevated creatine kinase levels due to muscle breakdown, but there are no specific tests for Bz in the body.

Treatment

Treatment of Bz exposure is primarily supportive. Key aspects of management include:

• Ensuring a safe environment to prevent injury during delirium
• Benzodiazepines for sedation and seizure control
• Intravenous fluids to maintain hydration and electrolyte balance
• Cooling measures for hyperthermia

Prevention

Prevention of Bz exposure involves avoiding areas where the agent may be used, such as in military or chemical warfare scenarios. Personal protective equipment, such as gas masks and protective clothing, can reduce the risk of exposure.

History and Use

Bz was developed in the 1950s as a potential chemical warfare agent due to its incapacitating effects. It was stockpiled by several countries but has since been largely abandoned in favor of more effective agents. Bz is classified as a Schedule 2 substance under the Chemical Weapons Convention.

See Also

• Anticholinergic syndrome
• Chemical warfare
• Incapacitating agent