Medication Summary
No medications are specific to the treatment of phosgene oxime exposure. The emergency department physician should use analgesics and topical antibiotics as preferred. [12, 13]
Parenteral analgesics
Class Summary
CX injuries are extremely painful and require liberal use of parenteral analgesics. No recommendations for specific parenteral analgesics are available. Select a medication (eg, morphine, meperidine) that is readily available and provides adequate pain relief for the patient.
Morphine sulfate (Duramorph, Astramorph, MS Contin)
An alkaloid of opium and a commonly used systemic narcotic analgesic; a good first choice parenteral medication that may be titrated to patient needs.
Meperidine (Demerol)
Narcotic analgesic with multiple actions qualitatively similar to those of morphine, typically administered in conjunction with promethazine.
Topical antibiotic ointments
Class Summary
Indicated for treatment of CX injury of skin and eyes; no specific ointments are recommended; select an available broad-spectrum ophthalmic or skin preparation (eg, bacitracin, Ilotycin).
Bacitracin (AK-Tracin, Baciguent)
Broad-spectrum antibiotic topical ointment that is a good first choice for superficial wound care.
Erythromycin ophthalmic (Ilotycin, E-mycin)
Broad-spectrum macrolide antibiotic indicated in treatment or prevention of superficial ocular infections.
Oral analgesics
Class Summary
Patients may be switched from parenteral analgesics to an oral form once their injuries have improved sufficiently to tolerate alternative pain control measures; no specific recommendations are available; use a readily available product (eg, Percocet, Tylenol with codeine) that provides adequate pain relief and is well tolerated by the patient.
Oxycodone/acetaminophen (Percocet)
Semisynthetic opioid analgesic with multiple actions similar to those of morphine; acetaminophen is a nonopiate nonsalicylate analgesic and antipyretic.
Acetaminophen/codeine (Tylenol with codeine)
Combines analgesic effects of a centrally acting opium-derived alkaloid (codeine) and a peripherally acting nonopioid analgesic (acetaminophen).
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Anteroposterior portable chest radiograph in a male patient who developed phosgene-induced adult respiratory distress syndrome. Notice the bilateral infiltrates and ground glass appearance.
