pralidoxime compounds


Summary: Various salts of a quaternary ammonium oxime that reconstitute inactivated acetylcholinesterase, especially at the neuromuscular junction, and may cause neuromuscular blockade. They are used as antidotes to organophosphorus poisoning as chlorides, iodides, methanesulfonates (mesylates), or other salts.

Top Publications

  1. Pawar K, Bhoite R, Pillay C, Chavan S, Malshikare D, Garad S. Continuous pralidoxime infusion versus repeated bolus injection to treat organophosphorus pesticide poisoning: a randomised controlled trial. Lancet. 2006;368:2136-41 pubmed
    ..We aimed to assess the effectiveness of a constant pralidoxime infusion compared with repeated bolus doses to treat patients with moderately severe poisoning from organophosphorus pesticides...
  2. Khan S, Hemalatha R, Jeyaseelan L, Oommen A, Zachariah A. Neuroparalysis and oxime efficacy in organophosphate poisoning: a study of butyrylcholinesterase. Hum Exp Toxicol. 2001;20:169-74 pubmed
  3. Sungur M, Guven M. Intensive care management of organophosphate insecticide poisoning. Crit Care. 2001;5:211-5 pubmed
    ..The clinical course of OP poisoning may be quite severe and may need intensive care management. We report our experience with the intensive care management of serious OP insecticide poisonings...
  4. Eddleston M, Szinicz L, Eyer P, Buckley N. Oximes in acute organophosphorus pesticide poisoning: a systematic review of clinical trials. QJM. 2002;95:275-83 pubmed
    ..Standard treatment involves the administration of intravenous atropine and an oxime to counter acetylcholinesterase inhibition at the synapse, but the usefulness of oximes is uncertain...
  5. Worek F, Reiter G, Eyer P, Szinicz L. Reactivation kinetics of acetylcholinesterase from different species inhibited by highly toxic organophosphates. Arch Toxicol. 2002;76:523-9 pubmed
    ..The results show marked differences among the species, depending on the inhibitor and on the oxime, and indicate that the findings from animal experiments need careful evaluation before extrapolating these data to humans...
  6. Eddleston M, Eyer P, Worek F, Mohamed F, Senarathna L, von Meyer L, et al. Differences between organophosphorus insecticides in human self-poisoning: a prospective cohort study. Lancet. 2005;366:1452-9 pubmed
    ..We aimed to determine whether the three most common organophosphorus insecticides used for self-poisoning in Sri Lanka differ in the clinical features and severity of poisoning they cause...
  7. Peter J, Moran J, Graham P. Oxime therapy and outcomes in human organophosphate poisoning: an evaluation using meta-analytic techniques. Crit Care Med. 2006;34:502-10 pubmed
    ..The status of oximes in human organophosphate poisoning is controversial. This analysis compares the outcomes of therapy with or without oximes...
  8. Abdullat I, Battah A, Hadidi K. The use of serial measurement of plasma cholinesterase in the management of acute poisoning with organophosphates and carbamates. Forensic Sci Int. 2006;162:126-30 pubmed
    ..To evaluate the benefits of using serial measurements of plasma cholinesterase (butyrylcholinesterase, BuChE) activity in the management of cholinesterase inhibitor insecticidal poisoning...
  9. Eyer P, Buckley N. Pralidoxime for organophosphate poisoning. Lancet. 2006;368:2110-1 pubmed

More Information

Publications108 found, 100 shown here

  1. Aurbek N, Thiermann H, Eyer F, Eyer P, Worek F. Suitability of human butyrylcholinesterase as therapeutic marker and pseudo catalytic scavenger in organophosphate poisoning: a kinetic analysis. Toxicology. 2009;259:133-9 pubmed publisher
    ..Furthermore, oxime-induced reactivation is too slow to accomplish a pseudo catalytic function, so that administered BChE may be merely effective as a stoichiometric scavenger...
  2. Eddleston M, Eyer P, Worek F, Juszczak E, Alder N, Mohamed F, et al. Pralidoxime in acute organophosphorus insecticide poisoning--a randomised controlled trial. PLoS Med. 2009;6:e1000104 pubmed publisher
    ..Although the World Health Organization recommends use of pralidoxime, this antidote's effectiveness remains unclear. We aimed to determine whether the addition of pralidoxime chloride to atropine and supportive care offers benefit...
  3. Luo C, Liang J. Evaluation of combined toxic effects of GB/GF and efficacy of jielin injection against combined poisoning in mice. Toxicol Lett. 1997;92:195-200 pubmed
    ..Results of in vitro reactivation of GF-inhibited human erythrocyte acetylcholinesterase by these oximes agreed with the in vivo antidotal efficacy. ..
  4. Nelson L, Perrone J, DeRoos F, Stork C, Hoffman R. Aldicarb poisoning by an illicit rodenticide imported into the United States: Tres Pasitos. J Toxicol Clin Toxicol. 2001;39:447-52 pubmed
    ..This study characterizes the ongoing epidemic of acute cholinesterase inhibitor poisoning due to an illicit rodenticide and identifies its etiology...
  5. Soummer A, Megarbane B, Boroli F, Arbelot C, Saleh M, Moesch C, et al. Severe and prolonged neurologic toxicity following subcutaneous chlorpyrifos self-administration: a case report. Clin Toxicol (Phila). 2011;49:124-7 pubmed publisher
    ..Subcutaneous chlorpyrifos self-injection may result in severe toxicity with prolonged neurologic injury, atypical overlapping electrophysiological patterns, and a poor final outcome. ..
  6. Fujino Y, Inoue Y, Onodera M, Endo K, Endo S, Nakayama H, et al. [Three cases of organophosphate poisoning treated with pralidoxime iodide and whole-bowel irrigation]. Chudoku Kenkyu. 2004;17:273-7 pubmed
    ..Serum ChE improved within two days. These cases suggest the possibility that preferential whole-bowel irrigation without atropine sulfate prevents the persistence or recurrence of the toxic effects of organophosphate. ..
  7. Sánchez Fortún S, Barahona M. Toxicity and characterization of cholinesterase-inhibition induced by diisopropyl fluorophosphate in Artemia salina larvae. Ecotoxicol Environ Saf. 2009;72:775-80 pubmed publisher
    ..These results suggest that the combinations of atropine plus 2-PAM or physostigmine are effective in the prevention of the lethal effects induced by DFP in A. salina larvae. ..
  8. Petroianu G. The history of pyridinium oximes as nerve gas antidotes: the British contribution. Pharmazie. 2013;68:916-8 pubmed
    ..The present contribution attempts to shed some light on the life and work of the people who contributed to the early development of cholinesterase reactivators, the pyridinium aldoximes at Porton. ..
  9. Newmark J. Therapy for nerve agent poisoning. Arch Neurol. 2004;61:649-52 pubmed
    ..These agents cause rapid-onset cholinergic crisis amenable to prompt treatment with specific antidotes. Experience on the battlefield and in terrorist attacks demonstrates that therapy saves lives. ..
  10. Foltin G, Tunik M, Curran J, Marshall L, Bove J, Van Amerongen R, et al. Pediatric nerve agent poisoning: medical and operational considerations for emergency medical services in a large American city. Pediatr Emerg Care. 2006;22:239-44 pubmed
    ..We conclude that the above approach is likely a safe and effective alternative to weight-based dosing of children, which will be nearly impossible to attain under field conditions. ..
  11. Lin T, Jiang D, Chan H, Hung D, Li H. Prognostic factors of organophosphate poisoning between the death and survival groups. Kaohsiung J Med Sci. 2007;23:176-82 pubmed
    ..Prolonged coma duration, lower level of acetylcholinesterase and lower level of plasma cholinesterase were related to the poor prognosis of the patients. ..
  12. Petroianu G. The history of cholinesterase reactivation: hydroxylamine and pyridinium aldoximes. Pharmazie. 2012;67:874-9 pubmed
    ..Finally Wilson and Ginsburg using 2-methyl-pyridine as a starting point synthesized the first pyridinium aldoxime reactivator of clinical relevance, pralidoxime (1955). ..
  13. Aygun D. Diagnosis in an acute organophosphate poisoning: report of three interesting cases and review of the literature. Eur J Emerg Med. 2004;11:55-8 pubmed
  14. Goel A, Aggarwal P, Bhoi S, Gupta V. High-dose pralidoxime for organophosphorus poisoning. Lancet. 2007;369:1425 pubmed publisher
  15. Shih T, Skovira J, O Donnell J, McDonough J. In vivo reactivation by oximes of inhibited blood, brain and peripheral tissue cholinesterase activity following exposure to nerve agents in guinea pigs. Chem Biol Interact. 2010;187:207-14 pubmed publisher
  16. Yan L, Chen J, Xu B, Guo L, Xie Y, Tang J, et al. A liquid chromatography tandem mass spectrometric method on in vitro nerve agents poisoning characterization and reactivator efficacy evaluation by determination of specific peptide adducts in acetylcholinesterase. J Chromatogr A. 2016;1450:86-93 pubmed publisher
    ..Our results showed that this method is a promising tool for the characterization of NAs poisoning and the evaluation of reactivator efficacy. ..
  17. Wood S. Nerve agent toxicology. JEMS. 2003;28:16; author reply 16 pubmed
  18. Binelli A, Ricciardi F, Riva C, Provini A. New evidences for old biomarkers: effects of several xenobiotics on EROD and AChE activities in Zebra mussel (Dreissena polymorpha). Chemosphere. 2006;62:510-9 pubmed
    ..The possible use of the oxime Pyridine-2-Aldoxime Methochloride (2-PAM) to bring back the catalytic activity to basal levels was also demonstrated. ..
  19. Picha J, Kuca K, Kivala M, Kohout M, Cabal J, Liska F. A new group of monoquaternary reactivators of acetylcholinesterase inhibited by nerve agents. J Enzyme Inhib Med Chem. 2005;20:233-7 pubmed
    ..Three newly synthesized oximes achieved similar nucleophilicity at the similar pKa according to 4-PAM, which is very promising for using these derivatives as AChE reactivators. ..
  20. Lorke D, Hasan M, Nurulain S, Shafiullah M, Nagelkerke N, Petroianu G. Effect of intrathecal pralidoxime administration upon survival of rats exposed to the organophosphate paraoxon. Neurotoxicology. 2008;29:663-70 pubmed publisher
    ..Supplementary injection of pentobarbital, presumably by its anticonvulsive action, has a superior efficacy compared to 2-PAM i.p. alone, irrespective of additional intrathecal 2-PAM administration. ..
  21. Basher A, Rahman S, Ghose A, Arif S, Faiz M, Dawson A. Phase II study of magnesium sulfate in acute organophosphate pesticide poisoning. Clin Toxicol (Phila). 2013;51:35-40 pubmed publisher
    ..Six patients died in control group compared to 3 in 4 gm, 2 in 8 gm and 1 in 12 gm group. There was no mortality in 16 gm group. Magnesium was well tolerated in this study. Larger studies are required to examine for efficacy. ..
  22. Bilgin T, Camdeviren H, Yapici D, Doruk N, Altunkan A, Altunkan Z, et al. The comparison of the efficacy of scoring systems in organophosphate poisoning. Toxicol Ind Health. 2005;21:141-6 pubmed
  23. Joshi R, Kalantri S. High-dose pralidoxime for organophosphorus poisoning. Lancet. 2007;369:1426 pubmed publisher
  24. Hoskovcova M, Halamek E, Kobliha Z, Tusarová I. Reactivation of immobilized acetylcholinesterase-tabun complex by pralidoxime, its isomers, and homologs. Toxicol Mech Methods. 2010;20:223-6 pubmed publisher
    ..No marked effect on the efficacy of the reactivators was observed on prolongation of the reactivation time. The reactivators efficacy decreased with decreasing concentration of their solutions. ..
  25. Worek F, Thiermann H, Szinicz L. Reactivation and aging kinetics of human acetylcholinesterase inhibited by organophosphonylcholines. Arch Toxicol. 2004;78:212-7 pubmed
  26. Hasan M, Nurulain S, Arafat K, Naseer O, Petroianu G. In vivo metoclopramide protection of cholinesterase from paraoxon inhibition: direct comparison with pralidoxime in subchronic low-dose exposure. J Appl Toxicol. 2004;24:257-60 pubmed
    ..Metoclopramide, in addition to being less effective as an RBC-AChE protective agent, also caused a failure to thrive in the POX+MCP-exposed rats, as evidenced by the changes in body weight. ..
  27. Kalkan S, Ergur B, Akgun A, Kaplan Y, Kinay A, Tuncok Y. Efficacy of an adenosine A1 receptor agonist compared with atropine and pralidoxime in a rat model of organophosphate poisoning. Hum Exp Toxicol. 2005;24:369-75 pubmed
    ..Further studies are needed involving a combination of PAM and/or atropine with repeated doses of PIA to clarify the efficacy of adenosine agonists in OP poisoning. ..
  28. Xu Y, Cai W, Nappi J, Yoshida H. Fecal-tagging CT colonography with structure-analysis electronic cleansing for detection of colorectal flat lesions. Eur J Radiol. 2012;81:1712-6 pubmed publisher
    ..The fecal-tagging CTC with structure-analysis electronic cleansing could yield a high sensitivity for detecting flat lesions ?4mm. The not-on-fold flat lesions were detected with higher sensitivity than on-fold flat lesions. ..
  29. Yorimitsu M, Yokoyama K, Nitatori T, Yoshino H, Isono S, Kuhara S. Whole-heart 3D late gadolinium-enhanced MR imaging: investigation of optimal scan parameters and clinical usefulness. Magn Reson Med Sci. 2012;11:9-16 pubmed
    ..WH-LGE yields high resolution images during free breathing and is considered useful for accurately estimating the area and transmural extent of myocardial infarction. ..
  30. Nagase S, Kohguchi K, Tohyama K, Watanabe M, Iwatani Y. Interference by pralidoxime (PAM) salts in clinical laboratory tests. Clin Chim Acta. 2013;416:72-9 pubmed publisher
    ..PAM iodide increases the GLU values measured by the enzyme electrode method, and PAM salts affected the values measured at 340 nm by absorption spectrophotometry in many other clinical test items. ..
  31. Tsatsakis A, Bertsias G, Liakou V, Mammas I, Stiakakis I, Tzanakakis G. Severe fenthion intoxications due to ingestion and inhalation with survival outcome. Hum Exp Toxicol. 2002;21:49-54 pubmed
    ..The clinical and toxicological data of the poisonings are discussed, as well as the potential therapeutic use of pralidoxime in organophosphate intoxication. ..
  32. Mattingly J, Sullivan J, Spiller H, Bosse G. Intermediate syndrome after exposure to chlorpyrifos in a 16-month-old girl. J Emerg Med. 2003;25:379-81 pubmed
    ..This is an unusual case in that it occurred in a young child, was related to chlorpyrifos, and occurred despite continuous and adequate oxime therapy. ..
  33. Zhu Q, Huang J, Lin Z. [Therapeutic efficacy of pralidoxime chloride on acute dichlorvos poisoning]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2005;23:91-3 pubmed
    ..PAM-Cl has therapeutic efficacy against acute toxicity of DDV through its reactivation of inhibited ChE. ..
  34. Bayir A, Kara H, Koylu O, Kocabas R, Ak A. The effects of ubiquinone (CoQ10) on heart tissue in cardiac toxicity related to organophosphate poisoning. Hum Exp Toxicol. 2013;32:45-52 pubmed publisher
    ..01). Treatment of AOP with CoQ10 + PAM + atropine in this animal model had a beneficial effect on both erythrocyte and heart tissue lipid peroxidation and AChE activity. ..
  35. Paget C, Menard S, Wroblewski I, Gout J, Danel V, Bost M. [Acute organophosphate intoxication after using a anti-lice insecticide shampoo]. Arch Pediatr. 2002;9:913-6 pubmed
    ..Accidental poisoning by organophosphate insecticides may occur, due to the misuse of such substances as shampoo against lice. An accurate information for users is necessary. ..
  36. Santos R, Cavaliere M, Puga F, Narciso E, Pelegrino J, Calore E. Protective effect of early and late administration of pralidoxime against organophosphate muscle necrosis. Ecotoxicol Environ Saf. 2002;53:48-51 pubmed
  37. Vioque Fernández A, de Almeida E, Ballesteros J, García Barrera T, Gomez Ariza J, Lopez Barea J. Doñana National Park survey using crayfish (Procambarus clarkii) as bioindicator: esterase inhibition and pollutant levels. Toxicol Lett. 2007;168:260-8 pubmed
    ..However, no correlation exist between the pesticide concentration at different sites and the extent of esterase inhibition, indicating that other factors could affect esterase response of animals from polluted sites. ..
  38. Acharya J, Gupta A, Mazumder A, Dubey D. In vitro reactivation of sarin inhibited electric eel acetylcholinesterase by bis-pyridinium oximes bearing methoxy ether linkages. Toxicol In Vitro. 2008;22:525-30 pubmed
    ..3P-2 and 3P-3, respectively exhibited 80% and 69% regeneration of inhibited AChE, whereas 2-PAM (well known antidote for nerve agent poisoning) showed 42% regeneration...
  39. Kayouka M, Houze P, Risède P, Debray M, Baud F. Acute renal failure alters the kinetics of pralidoxime in rats. Toxicol Lett. 2009;184:61-6 pubmed publisher
    ..These results suggest that dosages of pralidoxime should be adjusted in organophosphate-poisoned humans with renal failure when using high dosage regimen of pralidoxime. ..
  40. Lynch M. Atropine use in children after nerve gas exposure. J Pediatr Nurs. 2005;20:477-84 pubmed
  41. Reiner E, Simeon Rudolf V. Pyridinium, imidazolium and quinuclidinium compounds: toxicity and antidotal effects against the nerve agents Tabun and Soman. Arh Hig Rada Toksikol. 2006;57:171-9 pubmed
  42. Hmouda H, Ben Salem C, Bouraoui K. Management of acute organophosphorus pesticide poisoning. Lancet. 2008;371:2169-70; author reply 2170-1 pubmed publisher
  43. Tanima D, Maisnam I, Kundu A, Saha S, Ghosh S, Maity A. Atypical central nervous system involvement in acute organophosphorous poisoning. J Assoc Physicians India. 2011;59:326-7 pubmed
    ..It is a manifestation of the intermediate syndrome described in OP poisoning. It may or may not be associated with neuroimaging changes in the striatum. We present a case of acute OP poisoning with interesting positive CT scan findings. ..
  44. Jin S, Sarkar K, Jin Y, Liu Y, Kokel D, van Ham T, et al. An in vivo zebrafish screen identifies organophosphate antidotes with diverse mechanisms of action. J Biomol Screen. 2013;18:108-15 pubmed publisher
    ..These findings suggest that zebrafish screens might be a broadly applicable approach for discovering compounds that counteract the toxic effects of accidental or malicious poisonous exposures. ..
  45. Das Gupta S, Ghosh A, Chowdhri B, Asthana S, Batra B. Actions and interactions of cholinolytics and cholinesterase reactivators in the treatment of acute organophosphorus toxicity. Drug Chem Toxicol. 1991;14:283-91 pubmed
    ..I. of 3.2 when administered with HS-6, another bispyridinium ChE reactivator. This beneficial effect of benactyzine is possibly due to its greater antimuscarinic effect in the central nervous system than atropine or dexetimide...
  46. Wan W, Xu M, Zou H, Lu A, Shen X, Chen Y. [The activity of blood cholinesterase in rats exposed to dimethypo after drug intervention]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2002;20:419-21 pubmed
    ..05), but at higher doses(1/4 and 1/2 of LD50) the effects of both were not so good. Pralidoxime methylchloride and unithiol could partly recover the activity of ChE inhibited by dimehypo. ..
  47. Bohnert S, Vair C, Mikler J. Development and validation of a sensitive HPLC method for the quantification of HI-6 in guinea pig plasma and evaluated in domestic swine. J Chromatogr B Analyt Technol Biomed Life Sci. 2010;878:1407-13 pubmed publisher
    ..This validated method allows for the analysis of low volume samples, increased sample numbers and is applicable to the determination of pharmacokinetic profiles and parameters. ..
  48. Fisar Z, Hroudova J, Korabecny J, Musilek K, Kuca K. In vitro effects of acetylcholinesterase reactivators on monoamine oxidase activity. Toxicol Lett. 2011;201:176-80 pubmed publisher
    ..Because oximes concentrations effective for MAO inhibition could not be achieved in vivo at the cerebral level, we suppose that oximes investigated do not interfere with brain MAO at therapeutically relevant concentrations. ..
  49. Kuca K, Cabal J, Kassa J, Jun D, Hrabinova M. In vitro potency of H oximes (HI-6, HLö-7), the oxime BI-6, and currently used oximes (pralidoxime, obidoxime, trimedoxime) to reactivate nerve agent-inhibited rat brain acetylcholinesterase. J Toxicol Environ Health A. 2006;69:1431-40 pubmed
    ..More than one oxime may be necessary for the antidotal treatment of nerve agent-exposed individuals...
  50. Becker G, Kawan A, Gutzeit D, Worek F, Szinicz L. Direct reaction of oximes with crotylsarin, cyclosarin, or VX in vitro. Arch Toxicol. 2007;81:415-20 pubmed
  51. Tsai J, Sheu C, Cheng M, Hung J, Wang C, Chong I, et al. Organophosphate poisoning: 10 years of experience in southern Taiwan. Kaohsiung J Med Sci. 2007;23:112-9 pubmed
    ..Physicians must be aware of the potential dangers of respiratory failure, which could occur within 72 hours of OPP...
  52. DeMar J, Clarkson E, Ratcliffe R, Campbell A, Thangavelu S, Herdman C, et al. Pro-2-PAM therapy for central and peripheral cholinesterases. Chem Biol Interact. 2010;187:191-8 pubmed publisher
    ..Pro-2-PAM represents the first non-invasive means of administering a CNS therapeutic for the deleterious effects of OP poisoning by reactivating CNS AChE...
  53. Levy A, Chapman S, Cohen G, Raveh L, Rabinovitz I, Manistersky E, et al. Protection and inflammatory markers following exposure of guinea pigs to sarin vapour: comparative efficacy of three oximes. J Appl Toxicol. 2004;24:501-4 pubmed
    ..iii) Histamine release and eosinophilia following sarin inhalation might require additional intervention, aimed at reducing the symptoms of allergic reaction and possibly expediting recovery...
  54. Satar S, Satar D, Tap O, Koseoglu Z, Kaya M. Ultrastructural changes in rat liver treated with pralidoxime following acute organophosphate poisoning. Mt Sinai J Med. 2004;71:405-10 pubmed
    ..None of these changes were noted in Group 3. These findings suggest that acute organophosphate poisoning causes serious histopathological effects in rat liver, but that these changes are reversible with appropriate treatment strategies...
  55. Kuca K, Cabal J, Jun D, Musilek K. In vitro reactivation potency of acetylcholinesterase reactivators--K074 and K075--to reactivate tabun-inhibited human brain cholinesterases. Neurotox Res. 2007;11:101-6 pubmed
    ..A second AChE reactivator, K075, does not attain as great a reactivation potency as K074, although its maximal reactivation (17%) was achieved at relevant concentrations for humans...
  56. Kayouka M, Houze P, Debray M, Baud F. Acute renal failure enhances the antidotal activity of pralidoxime towards paraoxon-induced respiratory toxicity. Toxicol Lett. 2009;189:48-56 pubmed publisher
    ..01). In conclusion, pralidoxime had partial and transient effects towards paraoxon-induced respiratory toxicity in control rats; and a complete and sustained correction in ARF rats...
  57. Bawaskar H, Joshi S. High-dose pralidoxime for organophosphorus poisoning. Lancet. 2007;369:1425; author reply 1427 pubmed
  58. Li Y, Tse M, Gawarammana I, Buckley N, Eddleston M. Systematic review of controlled clinical trials of gastric lavage in acute organophosphorus pesticide poisoning. Clin Toxicol (Phila). 2009;47:179-92 pubmed publisher
    ..Despite the recognition of adverse effects, gastric lavage is commonly done in Asia. We aimed to identify studies assessing its effectiveness...
  59. Thiermann H, Eyer P, Worek F. Muscle force and acetylcholinesterase activity in mouse hemidiaphragms exposed to paraoxon and treated by oximes in vitro. Toxicology. 2010;272:46-51 pubmed publisher
    ..Thus, the data presented strongly support the administration of appropriately dosed oximes, preferably obidoxime, in paraoxon-poisoned patients to restore paraoxon-impaired muscle force...
  60. Cometa M, Lorenzini P, Fortuna S, Volpe M, Meneguz A, Palmery M. In vitro inhibitory effect of aflatoxin B1 on acetylcholinesterase activity in mouse brain. Toxicology. 2005;206:125-35 pubmed
  61. Sumi Y, Oode Y, Tanaka H. Chinese dumpling scare hits Japan--a case of methamidophos food poisoning. J Toxicol Sci. 2008;33:485-6 pubmed
  62. Kalasz H, Szöko E, Tábi T, Petroianu G, Lorke D, Omar A, et al. Analysis of pralidoxime in serum, brain and CSF of rats. Med Chem. 2009;5:237-41 pubmed
  63. Collange B, Wheelock C, Rault M, Mazzia C, Capowiez Y, Sanchez Hernandez J. Inhibition, recovery and oxime-induced reactivation of muscle esterases following chlorpyrifos exposure in the earthworm Lumbricus terrestris. Environ Pollut. 2010;158:2266-72 pubmed publisher
  64. Houze P, Borron S, Scherninski F, Bousquet B, Gourmel B, Baud F. Measurement of serum pralidoxime methylsulfate (Contrathion) by high-performance liquid chromatography with electrochemical detection. J Chromatogr B Analyt Technol Biomed Life Sci. 2005;814:149-54 pubmed
    ..This assay was applied to the analysis of a serum from an organophosphorate poisoned patient and treated by Contrathion infusions (100 and 200 mg h(-1)) after a loading dose (400 mg)...
  65. Kuca K, Jun D. Reactivation of sarin-inhibited pig brain acetylcholinesterase using oxime antidotes. J Med Toxicol. 2006;2:141-6 pubmed
    ..Organophosphorus nerve agents inhibit the enzyme, acetylcholinesterase (AChE; EC AChE reactivators (also known as oximes) are generally used for the reactivation of an inhibited enzyme...
  66. Kayouka M, Houze P, Baud F, Cisternino S, Debray M, Risède P, et al. Does modulation of organic cation transporters improve pralidoxime activity in an animal model of organophosphate poisoning?. Crit Care Med. 2011;39:803-11 pubmed publisher
    ..2) Assess whether sustained high plasma concentrations increase pralidoxime antidotal activity toward paraoxon-induced respiratory toxicity...
  67. Hoffman R, Mercurio Zappala M, Bouchard N, Ravikumar P, Goldfrank L. Preparing for chemical terrorism: a study of the stability of expired pralidoxime (2-PAM). Disaster Med Public Health Prep. 2012;6:20-5 pubmed publisher
    ..Because 2-PAM is often dosed empirically, clinical improvement does not guarantee pharmacological stability. We therefore chose to analyze the chemical stability of expired 2-PAM...
  68. Lallement G, Clarencon D, Galonnier M, Baubichon D, Burckhart M, Peoc h M. Acute soman poisoning in primates neither pretreated nor receiving immediate therapy: value of gacyclidine (GK-11) in delayed medical support. Arch Toxicol. 1999;73:115-22 pubmed
    ..However, it should always be kept in mind that, in the case of severe OP-poisoning, medical intervention must be conducted as early as possible...
  69. Petroianu G, Lorke D, Hasan M, Adem A, Sheen R, Nurulain S, et al. Paraoxon has only a minimal effect on pralidoxime brain concentration in rats. J Appl Toxicol. 2007;27:350-7 pubmed
    ..Brain perfusion does not significantly alter 2-PAM measurements and is therefore considered unnecessary...
  70. Abroug F. High-dose pralidoxime for organophosphorus poisoning. Lancet. 2007;369:1426-7; author reply 1427 pubmed
  71. Lawrence D, Kirk M. Chemical terrorism attacks: update on antidotes. Emerg Med Clin North Am. 2007;25:567-95; abstract xi pubmed
    ..This article is meant to introduce the clinician to several such agents, along with the antidotes useful in the management of exposure to these. It covers the indications, administration, and precautions for using these antidotes...
  72. Bhattarai M, Singh D, Chalise B, Koirala P. A case report and overview of organophosphate (OP) poisoning. Kathmandu Univ Med J (KUMJ). 2006;4:100-4 pubmed
    ..4%. The two important aspects of the management are vigilance of the atropine drip, especially at night, and other physical and psychological support care of the patients...
  73. Abbara C, Rousseau J, Turcant A, Lallement G, Comets E, Bardot I, et al. Bioavailability of diazepam after intramuscular injection of its water-soluble prodrug alone or with atropine-pralidoxime in healthy volunteers. Br J Pharmacol. 2009;157:1390-7 pubmed publisher
    ..The aim of this study was to assess the relative bioavailability of diazepam after administration of diazepam itself or as a water-soluble prodrug, avizafone, in humans...
  74. Lovrić J, Berend S, Lucić Vrdoljak A, Radic B, Katalinić M, Kovarik Z, et al. A conjugate of pyridine-4-aldoxime and atropine as a potential antidote against organophosphorus compounds poisoning. Acta Biochim Pol. 2011;58:193-8 pubmed
    ..It appears that ATR-4-OX has a therapeutic effect related to the reactivation of phosphylated AChE, but not to receptor antagonization...
  75. Cadieux C, Wang H, Zhang Y, Koenig J, Shih T, McDonough J, et al. Probing the activity of a non-oxime reactivator for acetylcholinesterase inhibited by organophosphorus nerve agents. Chem Biol Interact. 2016;259:133-141 pubmed publisher
    ..Finally, guinea pigs were used to examine the protective efficacy of the compound after exposure to sarin. The results of both in vitro and in vivo testing will be useful in the design of future small molecule reactivators. ..
  76. Jokanovic M, Maksimovic M. A comparison of trimedoxime, obidoxime, pralidoxime and HI-6 in the treatment of oral organophosphorus insecticide poisoning in the rat. Arch Toxicol. 1995;70:119-23 pubmed
    ..Trimedoxime was the most effective oxime in the treatment of insecticide poisoning, being successful especially at the lowest tested doses...
  77. Genovese R, Doctor B. Behavioral comparison of the oximes TMB-4, 2-PAM, and HI-6 in rats using operant conditioning. Pharmacol Biochem Behav. 1997;56:139-43 pubmed
    ..These results establish doses of each oxime that will not contribute to disruption of responding, and thus, facilitate future evaluation of bioscavenger therapies against OP toxicity...
  78. Shih T, McDonough J. Efficacy of biperiden and atropine as anticonvulsant treatment for organophosphorus nerve agent intoxication. Arch Toxicol. 2000;74:165-72 pubmed
    ..The present study demonstrates that all nerve agents can produce status epilepticus and that the therapeutic effectiveness of atropine and biperiden roughly paralleled the seizurogenic potential of these agents...
  79. Doorn J, Schall M, Gage D, Talley T, Thompson C, Richardson R. Identification of butyrylcholinesterase adducts after inhibition with isomalathion using mass spectrometry: difference in mechanism between (1R)- and (1S)-stereoisomers. Toxicol Appl Pharmacol. 2001;176:73-80 pubmed
    ..Furthermore, the data suggest that aging of the O,S-dimethyl phosphate adduct occurs via an S(N)2 process with loss of thiomethyl...
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    ..Here we have studied the pharmacokinetics of pralidoxime after its intramuscular injection alone or in combination with avizafone and atropine using an auto-injector device...
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    ..We therefore measured the systemic bioavailability of antidotes for organophosphorus nerve agent and cyanide poisoning when administered by the intraosseous, intravenous, and intramuscular routes in a small study of Göttingen minipigs...
  82. Kumar M, Kumar G, Babu P, Kumar S, Subrahmanyam B, Veeraprasad M, et al. A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. Ann Afr Med. 2014;13:71-5 pubmed publisher
    ..We have herein reported our experience with the pattern of presentation of cases of acute organophosphorus (OP) poisoning cases in a tertiary care hospital...
  83. Lieske C, Clark J, Maxwell D, Zoeffel L, Sultan W. Studies of the amplification of carbaryl toxicity by various oximes. Toxicol Lett. 1992;62:127-37 pubmed
    ..Our hypothesis is that certain oximes act as allosteric effectors of cholinesterases in carbaryl poisoning, resulting in enhanced inhibition rates and potentiation of carbaryl toxicity...
  84. Lallement G, Renault F, Baubichon D, Peoc h M, Burckhart M, Galonnier M, et al. Compared efficacy of diazepam or avizafone to prevent soman-induced electroencephalographic disturbances and neuropathology in primates: relationship to plasmatic benzodiazepine pharmacokinetics. Arch Toxicol. 2000;74:480-6 pubmed
    ..7 micromol diazepam/kg. Reflections on the possible incorporation of avizafone in three-drug emergency treatment are presented...
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    ..Investigations also showed that reactivation must be effected within 10 min after each analysis to eliminate the ageing effect, which reduces the efficiency of reactivation...
  86. Li J, Zhang Y, Du X, Sun M. [Reactivation and aging of acetylcholinesterase in human brain inhibited by phoxim and phoxim oxon in vitro]. Zhonghua Yu Fang Yi Xue Za Zhi. 2002;36:311-4 pubmed
    ..Inhibition of acetylcholinesterase (AChE) in human brain caused by phoxim or phoxim oxon, their reactivation with oxime and aging of phosphorylated AChE were studied and compared in vitro...
  87. Guven M, Sungur M, Eser B, Sari I, Altuntas F. The effects of fresh frozen plasma on cholinesterase levels and outcomes in patients with organophosphate poisoning. J Toxicol Clin Toxicol. 2004;42:617-23 pubmed
    ..The aim of this study is to determine the effects of fresh frozen plasma, as a source of cholinesterase, on butyrylcholinesterase (BuChE; plasma or pseudo cholinesterase) levels and outcomes in patients with organophosphate poisoning...
  88. Kuca K, Cabal J, Kassa J, Jun D, Hrabinova M. A comparison of the potency of the oxime HLö-7 and currently used oximes (HI-6, pralidoxime, obidoxime) to reactivate nerve agent-inhibited rat brain acetylcholinesterase by in vitro methods. Acta Medica (Hradec Kralove). 2005;48:81-6 pubmed
  89. Futagami K, Otsubo K, Nakao Y, Aoyama T, Iimori E, Urakami S, et al. Acute organophosphate poisoning after disulfoton ingestion. J Toxicol Clin Toxicol. 1995;33:151-5 pubmed
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  91. Kuca K, Cabal J. [In vitro reactivation of acetylcholinesterase inhibition by O-isopropylmethylfluorophosphonate using the bisquarternary oxime, HS-6]. Ceska Slov Farm. 2004;53:93-5 pubmed
    ..The oxime HS-6 was an effective reactivator of sarin-inhibited AChE. It is not as effective as the H-oxime HI-6, but it is better than 2-PAM and obidoxime...
  92. Barthold C, Schier J. Organic phosphorus compounds--nerve agents. Crit Care Clin. 2005;21:673-89, v-vi pubmed
    ..Goals of therapy include prevention and rapid treatment of hypoxia and seizures, as these are linked to patient outcome...