A Dutch Atropine Autoinjector
Pyridostigmine bromide enhances the effects of other antidotes by competitively inhibiting (binding to) acetylcholinesterase, and is taken in tablet form.
Pralidoxine is infused intravenously (1.5mg over 15 minutes) and continually repeated after 10 minutes until muscle control returns.
Soap and water. Despite sounding old fashioned, if VX in liquid form can be wiped off the skin quickly enough, victims have a chance of survival, particularly if they are taken to hospital and treated immediately.
Unfortunately, none of these three antidotes are useful in a widespread situation as they are all slow acting and require the assistance of a second party.
Atropine is a nerve gas itself, but is a suitable antidote to VX gas. Atropine acts by competitivly binding to the muscarinic (acetylcholine) receptors in the muscles. This prevents acetylcholine from binding to the receptors and sending impulses to the muscles. VX stimulates the muscles, so as atropine ceases the constant stimulation it acts as an antidote. With no acetylcholine reaching or binding to the receptors it is unimportant that the acetylcholinesterase is being destroyed by the VX Gas.
Atropine is injected intramuscularly (into the thigh) in 2mg doses every 3-8 minutes. If faster action is required, a direct injection into the heart will prevent death, effectively neutralising the effect of VX.
Below is an artist's impression of an atropine autoinjector used by the Dutch Armed Forces. Each marine is supplied with three autoinjectors. If VX exposure is indicated, a fellow soldier uses one autoinjector in the victim's thigh every six minutes.
A Dutch Atropine Autoinjector