ATNAA
Encyclopedia
An ATNAA is any of a variety of autoinjectors in use with the US Armed Forces. An autoinjector
Autoinjector
An autoinjector is a medical device designed to deliver a single dose of a particular drug....

 (or auto-injector) is a medical device designed to deliver a single dose of a particular (typically life-saving) drug.

Most autoinjectors are spring-loaded syringe
Syringe
A syringe is a simple pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed along inside a cylindrical tube , allowing the syringe to take in and expel a liquid or gas through an orifice at the open end of the tube...

s. By design, autoinjectors are easy to use and are intended for self-administration by patients. The site of injection depends on the drug loaded, but it typically is administered into the thigh or the buttocks. The injectors were initially designed to overcome the hesitation associated with self-administration of the needle-based drug delivery device. It is the newer delivery vehicle to be used in lieu of the Mark I NAAK
Mark I NAAK
The Mark I NAAK, or MARK I Kit, is United States military nomenclature for the "Nerve Agent Antidote Kit". It is a dual-chamber autoinjector: Two anti-nerve agent drugs — atropine sulfate and pralidoxime chloride — each in injectable form, constitute the kit. The kits are only effective against the...

.

Purpose

The ATNAA provides Atropine
Atropine
Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...

 and Pralidoxime chloride in a single delivery system although the two drugs are separate within the device. The use of the device is only to be administered in the extreme case of organophosphate poisoning
Organophosphate poisoning
Organophosphate poisoning results from exposure to organophosphates , which cause the inhibition of acetylcholinesterase leading to the accumulation of acetylcholine in the body. Organophosphate poisoning most commonly results from exposure to insecticides or nerve agents...

. The delivery system is designed for use by military personnel only, and is only issued to members in a combat zone where a threat of chemical attack is likely.

FDA approval

During initial trials and submission to the FDA for approval, the United States Department of Defense
United States Department of Defense
The United States Department of Defense is the U.S...

 requested that the FDA waive the requirement for a doctor's prescription for the ATNAA device; the rationale being that it would be issued en masse to troops. The waiver request was denied.

Training

As a condition of approval, the FDA lists on the device label the precise instructions that are to be given to military personnel on dosage and administration. While each branch of the DoD typically provides their own tailored training, an example of the MK I NAAK and ATNAA are referenced in the United States Air Force
United States Air Force
The United States Air Force is the aerial warfare service branch of the United States Armed Forces and one of the American uniformed services. Initially part of the United States Army, the USAF was formed as a separate branch of the military on September 18, 1947 under the National Security Act of...

 Self Aid Buddy Care Training (SABC)
Self Aid Buddy Care Training (SABC)
Self Aid Buddy Care is training of the United States Air Force SABC encompasses basic life support and limb-saving techniques to help wounded or injured personnel survive in medical emergencies until medical help is available.. SABC training is completed every 24 months and is administered to...

. SABC encompasses basic life support and limb-saving techniques to help wounded or injured personnel survive in medical emergencies until medical help is available.

See also

1. Meridian Meds: http://www.meridianmeds.com/pdf/ATNAA_Pack_Insert.pdf

2. Landauer, W: Cholinomimetic teratogens. V. The effect of oximes and related cholinesterase
reactivators. Teratology 15: 33 (Feb) 1977.

3. Moller, K.O., Jensen-Holm, J. and Lausen, H.H.: Ugeskr Laeg. 123: 501,1961.

4. Namba, T., Nolte, C.T., Jackrel, J. and Grob, D.: Poisoning due to organophosphate insecticides. Acute and chronic manifestations. Amer. J. Med. 50: 475 (Apr), 1971.

5. Arena, J.M.: Poisoning, Toxicology Symptoms, Treatments, ed. 4, Springfield, IL, Charles C.
Thomas, 1979, p. 133.

6. Brachfeld, J., and Zavon, M.R.: Organic phosphate (Phosdrin) intoxication. Report of a case and the results of treatment with 2-PAM, Arch. Environ. Health 11: 859, 1965.

7. Hayes, W.J., Jr.: Toxicology of Pesticides. Baltimore, The Williams & Wilkins Company, 1975, p. 416.
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