Clinical Pharmacology and Toxicology of Mustard Compounds

  • Adel Ghorani-Azam
  • Mahdi Balali-MoodEmail author


Sulfur mustard (SM) and nitrogen mustard (NM) are the two types of mustard compounds (MCs). SM has mainly been used as a chemical warfare agent (CWA), but NM has been administered as an anti-cancer drug. MCs are alkylating agents and initially synthesised for military purposes as a chemical blistering agent. However, they were also used as medications in the treatment of several diseases such as psoriasis and variety of cancers. MCs, especially SM can cause acute and chronic toxicities, particularly acute toxic effects and complications in the eyes, lungs, kidneys, skin and other vital organs in human. Several therapeutic strategies have been proposed so far to treat these complications, but no specific antidote has been introduced for these health problems. Conventional medical treatments with antioxidants e.g. N-acetyl cysteine and sodium thiosulfate and some anti-inflammatory drugs such as corticosteroids have been used, but their effects are not satisfactory. Nowadays, some new therapeutic strategies such as antimicrobial peptides, gene and stem cell therapy, and herbal medicines have been proposed for the treatment of SM complications.

In this chapter, we have reviewed clinical pharmacology of NM and acute, chronic and late clinical complications of SM poisoning in all affected organs. In addition, we have discussed conventional treatment as well as some new therapeutic approaches.


Sulfur mustard Nitrogen mustard Acute effects Chronic Poisoning Delayed toxicity Mustard gas Intoxication 



Alkylating agent

A molecule that transfer an alkyl group to target molecule, which acts as anticancer drugs by inhibiting DNA replication and transcription.


Chemical modification of a compound in the body of living organism.


A pulmonary disease in which some parts of lung airways is enlarged mainly due to inflammation or infection.


A calcium binding protein in eukaryotic cells that regulates biological activities of calcium dependent proteins in many cellular processes.

Chemical warfare agent (CWA)

A chemically toxic substance that are used as chemical weapons in battlefield.

Corneal conjunctivalization

The presence of goblet cells in the corneal epithelium.

Epigenetic therapy

The use of drugs or epigenome-influencing techniques to treat diseases.


Inflammation of the cornea.


Ability of a chemical compound to dissolve in lipids and non-polar solvents.

Nitrogen mustard (NM)\

A cytotoxic chemotherapy agents similar to sulfur mustard.

Organization for Prohibition of Chemical Weapons (OPCW)

An international organization for preventing the use of chemical warfare agents and collaborating with many academics to find suitable therapy for medical conditions caused by these agents.


Studies effects of a drug to the body.


Studies effects of the body to a drug.


The process in which lipids are accumulated in the liver cells.

Sulfur mustard (SM)

Also known as mustard gas, is a cytotoxic, alkylating and blistering chemical warfare agents.


The property or capability of producing congenital anomalies.


Inflammation of the bronchi.


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© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Medical Toxicology Research Center, Faculty of MedicineMashhad University of Medical SciencesMashhadIran

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