Nomenclature of radioprotective medical agents for major radiation accidents

The widespread use of nuclear and radiation technologies necessitates preparedness for response to radiological emergencies. The application of medical countermeasures aimed at mitigating the adverse effects of ionizing radiation is a key element of risk management and reduction strategies, particularly during the early phases of large-scale radiation accidents among emergency response personnel. Medical agents for radiation protection are used for preventive and therapeutic purposes in cases of external, internal, or combined exposure. The aim of this study is to substantiate the choice of modern medical countermeasures for radiological protection and their protocols for application across various radiation accident scenarios. Materials and Methods: A review of Russian and international scientific publications, normative and methodological documents, and official guidelines for the period 2010–2025 was conducted. Results and Discussion: The main scenarios requiring the use of medical countermeasures for radiation protection were identified. The principal groups of drugs, their mechanisms of action, and roles within the medical radiation protection system were determined. A comparative analysis of domestic and foreign nomenclature of radiation protection agents was performed. Conclusion: It was established that the Russian nomenclature of medical countermeasures is more universal and covers a wider range of radiological emergency scenarios compared with foreign systems. The choice of specific preparations should be determined case by case, depending on the type of accident, radiological conditions, and radionuclide composition of releases. Expansion of the range and stockpiling of medical countermeasures should be given particular attention as part of emergency preparedness activities.