Patients with severe poisoning showed greatly reduced consciousness levels, miosis, marked fasciculations, flushing, tachycardia, raised blood pressure, respiratory distress, and flaccid paralysis. Patients with mild poisoning complained of headaches, dizziness, nausea, chest discomfort, abdominal cramps, and showed marked miosis. 4 patients with severe poisoning requiring hospital admission had reduced cholinesterase values compared with those with mild poisoning (n=28) (mean [SD] 174-5 [85-1] vs 492-0 [104’9] IU/L, p<001; normal range 348-680 IU/L). None of the patients showed abnormal bradycardia or excess secretions, which are common manifestations of organophosphate poisoning. By contrast, tachycardia and raised blood pressure were often seen.
Treatment of organophosphate poisoning often aims to reduce secretions to prevent the patient from literally drowning, and to support the circulation in depressed cardiac states. We did not find such excess secretions in the Tokyo cases….
Atropine in patients with milder poisoning caused increased tachycardia and dryness of the mouth. The patients with severe poisoning responded well to pralidoxime iodide. This experience has shown that sarin gas poisoning produces nicotinic-dominant responses (eg, tachycardia, raised blood pressure, and fasciculations). Treatment can be based on the principles for organophosphate poisoning, although lack of excess secretions and bradycardia may preclude use of immediate medication in milder cases.
Т.е. рассказы в мурзилках и мануалах про "типичные" симптомы поражения ФОВ имеют очень низкую достоверность. Атропин может вызывать (примерно в 60% случаев) ухудшение состояния именно по причине усиления никотиновых симптомов. Ну и как писал ранее, надежных средств лечения поражения ФОВ и тем более надежных антидотов не существует. Все зависит от наличия медсопровождения, своевременности его применения и просто везения.