An ATNAA (Antidote Treatment Nerve Agent Autoinjector) is any of a variety of

autoinjector An autoinjector (or auto-injector) is a medical device for injection of a premeasured dose of a particular drug. Most autoinjectors are one-use, disposable, spring-loaded syringes (prefilled syringes). By design, autoinjectors are easy to use an ...

s in use with the US Armed Forces. An autoinjector is a medical device designed to deliver a single dose of a particular (typically life-saving) drug. Most autoinjectors are spring-loaded

syringe A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...

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 In the United States military, the Mark I NAAK, or MARK I Kit, ("Nerve Agent Antidote Kit") is a dual-chamber autoinjector: Two anti-nerve agent drugs— atropine sulfate and pralidoxime chloride—each in injectable form, constitute the kit. ...

Purpose

The ATNAA provides

atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically give ...

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 is poisoning due to organophosphates (OPs). Organophosphates are used as insecticides, medications, and nerve agents. Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, m ...

. The delivery system is designed for use by military personnel only, and is only issued to DOD personnel that are considered to be in immediate danger of a chemical attack or work in a position (such as ordnance disposal) where there is a high likelihood of

nerve agent Nerve agents, sometimes also called nerve gases, are a class of organic chemistry, organic chemicals that disrupt the mechanisms by which nerves transfer messages to organs. The disruption is caused by the blocking of acetylcholinesterase (ACh ...

exposure.

FDA approval

During initial trials and submission to the FDA for approval, the

United States Department of Defense The United States Department of Defense (DoD, USDOD, or DOD) is an United States federal executive departments, executive department of the federal government of the United States, U.S. federal government charged with coordinating and superv ...

requested that the

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) waive the requirement for the phrase 'Rx only' being included on the labeling for the ATNAA device; the rationale being that it would be confusing to troops. The waiver request was denied. The DoD opted to include the phrase at the end of the package insert instead, and this modification was found acceptable.

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 The United States Air Force (USAF) is the Air force, air service branch of the United States Department of Defense. It is one of the six United States Armed Forces and one of the eight uniformed services of the United States. Tracing its ori ...

Self Aid Buddy Care Training (SABC). SABC encompasses basic life support and limb-saving techniques to help wounded or injured personnel survive in medical emergencies until medical help is available.

Purpose

FDA approval

Training

References

Further reading