Acetylcholinesterase Inhibitors Toxicity


4.7 out of 5 (31 Reviews)



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Expiration Date

28 Feb 2026

Last Reviewed

1 Mar 2023

Estimated Time To Finish

90 Minutes

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Activity Description

Nerve agents are some of the most deadly and easily employed chemical warfare agents. Given the global threat of terrorism, it is prudent to have a baseline knowledge of nerve agents. Some of the more recognizable nerve agents are sarin [(RS)-propan-2-yl methyphosphonofluoridate], also known as GB; soman (O-Pinacolyl methylphosphonofluoridate), also known as GD; and VX (ethyl ({2-[bis(propan-2yl)amino]ethyl}sulfanyl)(methyl)phosphinate). Initially developed in the early-to-mid 1900s from chemically similar insecticides, their volatility and potential to be weaponized was exploited during World War II. More recent examples of nerve agent use include the 1995 Tokyo subway attack with Sarin gas and the 2017 assassination of Kim Jong-Nam with VX gas. This activity reviews some of the more common nerve agents used, their associated signs and symptoms, and recommendations for management. This activity reviews the importance of the interprofessional team in diagnosing and treating patients exposed to nerve agents.

Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Describe the signs and symptoms that a patient with acetylcholinesterase inhibitor toxicity might exhibit.
  • Identify the organ system most at risk of failing and thereby leading to mortality in patients with acetylcholinesterase inhibitor toxicity.
  • Explain important treatment considerations for patients with acetylcholinesterase inhibitor toxicity.
  • Identify the most likely setting in which the interprofessional team would be expected to deal with widespread acetylcholinesterase inhibitor toxicity. Describe how team members would communicate and collaborate to reduce the burden of the toxicity.


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COMMERCIAL SUPPORT: This activity has received NO commercial support.

Continuing Education Accreditation Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 1.50 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity is reported to the following Maintenance of Certification (MOC) boards:
American Board of Anesthesiology
  • General Operative Anesthesia
American Board of Internal Medicine
  • Adolescent Medicine
  • Hospital Medicine
  • Internal Medicine
American Board of Ophthalmology
  • Glaucoma
  • Neuro-Ophthalmology and Orbit
American Board of Pathology
  • Chemical Pathology
  • Forensic Pathology
  • Neuropathology (incl. Neuromuscular)
American Board of Pediatrics
  • Adolescent Medicine
  • General Pediatrics
  • Medical Toxicology
  • Pediatric Neurology

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content in the activity.
  4. Choose the best answer to each activity test question. To receive credit, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment.
  6. Obtain a certificate.

For information on the applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.


Faculty may discuss investigational products or off-label uses of products regulated by the US Food and Drug Administration. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on StatPearls specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Cancellation Policy: Cancellations must be received in writing and a money-back guarantee is provided if not completely satisfied.

  • StatPearlsand and Quillen College of Medicine, East Tennessee State University reserve the right to cancel any course due to unforeseen circumstances. StatPearls andQuillen College of Medicine, East Tennessee State University will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Medium or Media Used:

  • Computer Requirements: Internet Access
  • E-mail Address

Equal Opportunity

  • StatPearls andQuillen College of Medicine, East Tennessee State University are Equal Opportunity/Affirmative Action/Equal Access Institutions. 


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    Harry A. on 9/26/2021

    Thank you so much!! So valuable - I may never need it, but I'll be more likely to help now knowing this!

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    Edward M. on 3/31/2022

    very concise and to the point

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