Acetylcholinesterase Inhibitors Toxicity


4.8 out of 5 (56 Reviews)



Post Assessment Questions


Start Date

1 Sep 2023

Last Review Date

1 Sep 2023

Expiration Date

31 Aug 2026

Estimated Time To Finish

90 Minutes

Need Help?  If you have a system or content concerns, please contact

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, physician associates, nurses, pharmacists, and nurse practitioners.

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.


StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.


Physicians and Physician Associates: StatPearls, LLC designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)TM. Physicians and PAs should only claim credit commensurate with the extent of their participation in the activity.

American Board of Anesthesiology: This activity contributes to the CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website,, for a list of all MOCA 2.0 requirements.

American Board of Internal Medicine: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.50 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

American Board of Pathology: Successful completion of this Continuing Certification activity, which includes participation in the evaluation component, enables the participant to earn up to 1.50 Lifelong Learning (CME) credits in the American Board of Pathology’s Continuing Certification Program.

American Board of Pediatrics: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.50 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

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

Method of Participation and Credit

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

If you have concerns regarding the CE/CME system, please contact


This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. 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 expressly 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.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.




Deborah Z. on 1/10/2021

Sabrina C. on 2/26/2021

Mark C. on 4/17/2021

Ajith N. on 7/8/2021

Larry M. on 7/14/2021

Michelle W. on 8/19/2021

Alana H. on 8/23/2021

Sami A. on 9/16/2021

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!

lee a. on 10/1/2021

Kevin C. on 11/15/2021

Karl S. on 11/17/2021

Hillary C. on 1/6/2022

Bhupendra G. on 2/12/2022

Edward M. on 3/31/2022

very concise and to the point

Alexei K. on 3/8/2022

Ejaz J. on 5/30/2022

Brian G. on 6/11/2022

Paul M. on 6/26/2022

Dr. O. on 7/28/2022

Kara C. on 8/9/2022

Stacey G. on 8/27/2022

Katherine S. on 9/15/2022

Scott S. on 10/14/2022

Natalie p. on 1/4/2023

Florence Y. on 1/20/2023

Larry E. on 1/28/2023

Lillian O. on 2/19/2023

Bensson S. on 3/14/2023

Sarah S. on 3/16/2023

James M. on 3/23/2023

Rita O. on 4/4/2023

Theodore K. on 4/27/2023

Iftikhar A. on 5/21/2023

edwin g. on 5/22/2023

Leon B. on 6/17/2023

Tara B. on 6/25/2023

Christopher R. on 9/15/2023

Kenneth K. on 10/4/2023

LIDIA I. on 10/7/2023

Lazo K. on 10/25/2023

robert s. on 10/27/2023

Mark S. on 11/26/2023

Stephen G. on 11/30/2023

Alexei K. on 12/9/2023

Jovelie D. on 12/25/2023

Fred H. on 12/29/2023

John P. on 12/29/2023

Hooria I. on 1/3/2024

Jameson E. on 1/18/2024

Stephen C. on 1/19/2024

edwin g. on 1/24/2024

Lazo K. on 1/30/2024

john d. on 1/31/2024

brian w. on 2/3/2024

Dana H. on 2/8/2024

Unlimited Physician CME

Stay up to date on the latest medical knowledge with 6682 CME activities. In these online self-assessment activities, read our reference articles and test your knowledge with more than 7934.5 hours of CME.

Learn About Lifetime CME

Single Activity

Take this single activity

$73.50 1 activity

6 Month Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$399 per half year per user

1 Year Unlimited Physician CME

Access to all the Unlimited Physician CME activities in all specialties.

$599 per 1 year per user