Tabun, sarin, soman, VX and novichoks : Organophophate nerve agents for military or criminal purposes Tabún, sarín, somán, VX y novichoks: agentes neurotóxicos organofosforados con finalidad bélica o criminal

Several chemical agents were used systematically as weapons during the First World War. Years later the Nazis accidentally discovered the group G organophosphate nerve agents (OPNAs): tabun, sarin and soman; but surprisingly they did not use them, despite knowing their lethality. Later, during the Cold War, the NATO countries developed the OPNAs of group V, among which the VX stands out; and the USSR developed the most fearsome, the OPNAs of group A, among which the novichoks stand out. OPNAs fell into oblivion until they infamously resurfaced in the Halabja massacre (Iran-Iraq war, 1988), the Tokyo subway terrorist attack (1995) and the Ghouta bombing (Syrian war, 2013). But the military use has been redirected in recent years to selective assassinations committed by secret services: Skripal, Gebrev, Kim Jong-nam or Navalny cases. In addition, people close to the victims, health personnel for example, can also become intoxicated. OPNAs rapid and irreversibly inhibit acetylcholinesterase and their lethality is much higher than that of organophosphorus pesticides. The clinical picture is reminiscent of acute opiate intoxication but with generalized hypersecretion: hypersialorrhea, rhinorrhea, dacryorrhea, diarrhoea, bronchorrhea, etc. For this reason, it is known as "wet opioid toxyndrome". We review the history of the synthesis of OPNAs, the clinic that induces their exposure and their treatment: life support, decontamination, atropinization and antidotes.