may cause lasting nerve damage, resulting in permanent disablement of victims, according to Russian scientists. Their effect on humans was demonstrated by the accidental exposure of Andrei Zheleznyakov, one of the scientists involved in their development, to the residue of an unspecified Novichok agent while working in a Moscow laboratory in May 1987. He was critically injured and took ten days to recover consciousness after the incident. He lost the ability to walk and was treated at a secret clinic in Leningrad for three months afterwards. The agent caused permanent harm, with effects that included "chronic weakness in his arms, a toxic hepatitis that gave rise to cirrhosis of the liver, epilepsy, spells of severe depression, and an inability to read or concentrate that left him totally disabled and unable to work." He never recovered and, after five years of deteriorating health, died in July 1992. The use of a fast-acting peripheral anticholinergic drug such as atropine can block the receptors where acetylcholine acts to prevent poisoning (as in the treatment for poisoning by other acetylcholinesterase inhibitors). Atropine, however, is difficult to administer safely, because its effective dose for nerve agent poisoning is close to the dose at which patients suffer severe side effects, such as changes in heart rate and thickening of the bronchial secretions, which fill the lungs of someone suffering nerve agent poisoning so that suctioning of these secretions, and other advanced life support techniques, may be necessary in addition to administration of atropine to treat nerve agent poisoning. In the treatment of nerve agent poisoning, atropine is most often administered along with a Hagedorn oxime such as pralidoxime, obidoxime, TMB-4, or HI-6, which reactivates acetylcholinesterase which has been inactivated by phosphorylation by an organophosphorus nerve agent and relieves the respiratory muscle paralysis caused by some nerve agents. Pralidoxime is not effective in reactivating acetylcholinesterase inhibited by some older nerve agents such as soman or the Novichok nerve agents, described in the literature as being up to eight times more toxic than nerve agent VX. The US Army has funded studies of the use of galantamine along with atropine in the treatment of a number of nerve agents, including soman and the Novichok agents. An unexpected synergistic interaction was seen to occur between galantamine (given between five hours before to thirty minutes after exposure) and atropine in an amount of 6 mg/kg or higher. Increasing the dose