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                     ~Oll OFFICIAL ~~~E ONL7
                              ANNEX D

 (Use of Pyridostigmine Tablets) to Operation Desert Storm NBC SOP

 1.  Pyridostiqmine, if taken prior t~ a nerve agent chemical
 attack, greatly enhances the effectiveness of subsequent nerve
 agent antidote treatment.  Although it is a very important part
 of a soldier1 S defense against a nerve agent attack, it is
 important to emphasize that it is noL tc) be used for treatment of
 a chemical casualty, and it will not prevent the effects of nerve
 agent from occurring.

 2.  Pyridostigmine tablets are issued aC; a blister pack
 containing 21 tablets. They are an individual issue item.
 Personnel may draw them from the CCH  NBC room if needed.

 3.  The Headquarters Commandant,  (in coordination with CCJ2,
 CCJ3, CCJ3-X, and CCSG) will make a recommendation to the
 USCENTCOM Chief of Staff when it is Lime for personnel to start
 taking the pyridostigmine tablets.  `rhe CCCS will direct
 personnel assigned to HQ USCENTCOM wi en to start taking
 pyridostigmine.

 4.  The dose is one tablet, taken by mo~th, every eight hours.
 If a dose is missed, under no circum~tances should a soldier take
 two tablets as a "make up" dose.  In.~tead, the soldier should
 take one tablet and restart the eight hour schedule.

 5.  MOPP IV integrity will not be br~ken in order to ta)c~ the
 tablets, personnel will wait until t:~e MOPP IV condition is
 reduced.

 6.  Every three days CCCS will reass~ss the need for taking
 pyridostigmine.  Personnel will not take pyridostigmine for
 longer than seven consecutive days u:~less directed to do so by
 the CCCS due to a continued threat o~ nerve agent attack.

 7.  Approximately 1 in 1,000 personnel will experience side
 effects associated with use of pyridostigmine (ie. stomach
 irritability and minor skin rashes).  However, there is no
 decrement in mental or physical performance.


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                 BES~fl~Q7 A~ ~LAS~1FiLD Wr~~E
                                 10

DOWNGRADED FOR RELEASE 12 JAN 96
USCENTCOM HQCC

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