Please note that the content of this book primarily consists of articles
available from Wikipedia or other free sources online.Pralidoxime or
2-PAM, usually as the chloride or methiodide salts, belongs to a family
of compounds called oximes that bind to organophosphate-inactivated
acetylcholinesterase. It is used to combat poisoning by organophosphates
or acetylcholinesterase inhibitors (nerve agents), in conjunction with
atropine and diazepam. Pralidoxime reversibly binds to the enzyme
acetylcholinesterase, competing with organophosphate binding. However,
2-PAM does not inactivate the enzyme and is therefore thought to
dislodge or block organophosphates from inactivating
acetylcholinesterase. However, organophosphates ultimately irreversibly
bind to acetylcholinesterase, requiring early administration of 2-PAM.
Note that meta-analyses of the use of "-oximes" (like 2-PAM) in
organophosphate poisoning have not demonstrated any benefit (and their
use may be harmful). There are no controlled studies.
