TY - JOUR
T1 - Pyridostigmine, diethyltoluamide, permethrin, and stress
T2 - A double-blind, randomized, placebo-controlled trial to assess safety
AU - Roy, Michael J.
AU - Kraus, Patricia L.
AU - Seegers, Cynthia A.
AU - Young, Sylvia Y.N.
AU - Kamens, Deborah R.
AU - Law, Wendy A.
AU - Cherstniakova, Svetlana A.
AU - Chang, David N.
AU - Cooper, Jamie A.
AU - Sato, Paul A.
AU - Matulich, William
AU - Krantz, David S.
AU - Cantilena, Louis R.
AU - Deuster, Patricia A.
N1 - Funding Information:
This study was supported by a competitive grant from the US Army Medical Research Materiel Command under the Congressionally Directed Medical Research Programs, DAMD17-00-1-0715.
PY - 2006/10
Y1 - 2006/10
N2 - OBJECTIVE: To determine whether short-term human exposure to pyridostigmine bromide, diethyltoluamide, and permethrin, at rest or under stress, adversely affects short-term physical or neurocognitive performance. PARTICIPANTS AND METHODS: A multicenter, prospective, double-blind, placebo-controlled crossover trial exposing 64 volunteers to permethrin-impregnated uniforms, diethyltoluamide-containing skin cream, oral pyridostigmine, and corresponding placebos was performed. Each participant had 4 separate sessions, ensuring exposure to all treatments and placebos under both stress and rest conditions in random order. Outcomes included physical performance (handgrip strength and duration, stair climbing, and pull-ups [males] or push-ups [females]), nenrocognitive performance (computerized tests), and self-reported adverse effects. RESULTS: Permethrin was undetectable in the serum of all participants; pyridostigmine levels were higher immediately after stress (41.6 ng/mL; 95% confidence interval, 35.1-48.1 ng/ml) than rest (23.0 ng/ml; 95% confidence interval, 19.2-26.9 ng/ml), whereas diethyltoluamide levels did not significantly differ by stress condition. Heart rate and systolic blood pressure increased significantly with stress compared with rest but did not vary with treatment vs placebo. Physical and neurocognitive outcome measures and self-reported adverse effects did not significantly differ by exposure group. CONCLUSION: Combined, correct use of pyridostigmine, diethyltoluamide, and permethrin is well tolerated and without evidence of short-term physical or neurocagnitive impairment.
AB - OBJECTIVE: To determine whether short-term human exposure to pyridostigmine bromide, diethyltoluamide, and permethrin, at rest or under stress, adversely affects short-term physical or neurocognitive performance. PARTICIPANTS AND METHODS: A multicenter, prospective, double-blind, placebo-controlled crossover trial exposing 64 volunteers to permethrin-impregnated uniforms, diethyltoluamide-containing skin cream, oral pyridostigmine, and corresponding placebos was performed. Each participant had 4 separate sessions, ensuring exposure to all treatments and placebos under both stress and rest conditions in random order. Outcomes included physical performance (handgrip strength and duration, stair climbing, and pull-ups [males] or push-ups [females]), nenrocognitive performance (computerized tests), and self-reported adverse effects. RESULTS: Permethrin was undetectable in the serum of all participants; pyridostigmine levels were higher immediately after stress (41.6 ng/mL; 95% confidence interval, 35.1-48.1 ng/ml) than rest (23.0 ng/ml; 95% confidence interval, 19.2-26.9 ng/ml), whereas diethyltoluamide levels did not significantly differ by stress condition. Heart rate and systolic blood pressure increased significantly with stress compared with rest but did not vary with treatment vs placebo. Physical and neurocognitive outcome measures and self-reported adverse effects did not significantly differ by exposure group. CONCLUSION: Combined, correct use of pyridostigmine, diethyltoluamide, and permethrin is well tolerated and without evidence of short-term physical or neurocagnitive impairment.
UR - http://www.scopus.com/inward/record.url?scp=33749257995&partnerID=8YFLogxK
U2 - 10.4065/81.10.1303
DO - 10.4065/81.10.1303
M3 - Article
AN - SCOPUS:33749257995
SN - 0025-6196
VL - 81
SP - 1303
EP - 1310
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 10
ER -