Page last updated: 2024-10-15

pralidoxime

Description

pralidoxime: RN given refers to parent cpd; chloride was minor descriptor (75-80); on-line & Index Medicus search PRALIDOXIME COMPOUNDS (66-80) [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

pralidoxime : A pyridinium ion that is 1-methylpyridinium substituted by a (hydroxyimino)methyl group at position 2. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID135398747
CHEBI ID8354
SCHEMBL ID439968
MeSH IDM0092337

Synonyms (50)

Synonym
PRESTWICK2_000943
IDI1_000770
BPBIO1_000998
SPECTRUM5_001138
BSPBIO_000906
pralidoximum
2-[(e)-(hydroxyimino)methyl]-1-methylpyridinium
CHEBI:8354 ,
BSPBIO_003115
2-pam
94-63-3
nsc164614
(2e)-1-methylpyridin-1-ium-2-carbaldehyde oxime
nsc7760
pyridinium, 2-((hydroxyimino)methyl)-1-methyl-, iodide
AB00513971
fp1 ,
6735-59-7
pralidoxime
C07400 ,
DB00733
PRESTWICK3_000943
2-hydroxyiminomethyl-1-methylpyridinium
1-methylpyridinium-2-aldoxime ion
pralidoxime ion
pralidoxime cation
2-((hydroxyimino)methyl)-1-methylpyridinium
pralidoxime [inn:ban]
einecs 229-787-0
hsdb 8490
AKOS005207264
P7MU9UTP52 ,
25615-00-3
pralidoxime [vandf]
pralidoxime [mart.]
pralidoxime [who-dd]
SCHEMBL439968
DTXSID1044144 ,
AB00572627_09
bdbm234367
pralidoxime (3)
unii-p7mu9utp52
(ne)-n-[(1-methylpyridin-1-ium-2-yl)methylidene]hydroxylamine
1-methyl-2-pyridinium aldoxime
HY-B1738
CS-0013750
pralidoxime (mart.)
pralidoxima
dtxcid9024144
pralidoxim

Research Excerpts

Overview

Pralidoxime is an organic cation used as an antidote in addition to atropine to treat organophosphate poisoning. Studies have also reported pralidoxime's pressor effect, which may facilitate the restoration of spontaneous circulation after cardiac arrest.

ExcerptReference
"Pralidoxime is a common antidote for organophosphate poisoning; however, studies have also reported pralidoxime's pressor effect, which may facilitate the restoration of spontaneous circulation (ROSC) after cardiac arrest by improving coronary perfusion pressure (CPP). "( Pralidoxime administered during cardiopulmonary resuscitation facilitates successful resuscitation in a pig model of cardiac arrest.
Heo, T; Jeung, KW; Jung, YH; Lee, BK; Lee, HY; Min, YI; Youn, CS; Yun, SW, 2020
)
"Pralidoxime is an organic cation used as an antidote in addition to atropine to treat organophosphate poisoning. "( Does modulation of organic cation transporters improve pralidoxime activity in an animal model of organophosphate poisoning?
Baud, FJ; Cisternino, S; Debray, M; Houzé, P; Kayouka, M; Risède, P; Schinkel, AH; Warnet, JM, 2011
)
"Pralidoxime (2-PAM) is a monopyridinium oxime used as an antidote for the treatment of poisoning with organophosphorus (OP) compounds, for example, pesticides and nerve agents, reactivating OP-inhibited acetylcholinesterase. "( Quantification of pralidoxime (2-PAM) in urine by ion pair chromatography-diode array detection: application to in vivo samples from minipig.
Eddie Clutton, R; Eddleston, M; John, H; Thiermann, H; Worek, F,
)
"Pralidoxime chloride is a useful agent in the treatment of organophosphate poisoning. "( Therapeutic dosing of pralidoxime chloride.
Greenwood, RB; Thompson, DF; Thompson, GD; Trammel, HL,
)

Toxicity

Pradalidoxime is a drug used to treat carbamate poisoning in children. Adverse drug reactions to the drug in children are rare, according to this study.

ExcerptReference
" LD50 of CMPF was estimated using an up-and-down dose selection procedure and 12 animals."( Evaluation of the toxicity, pathology, and treatment of cyclohexylmethylphosphonofluoridate (CMPF) poisoning in rhesus monkeys.
Dochterman, LW; Gresham, VC; Kaminskis, A; Koplovitz, I; Stewart, JR, 1992
)
"Soman inhibits the enzyme acetylcholinesterase, essentially irreversibly, producing an accumulation of acetylcholine (ACh) which is responsible for many of its toxic effects."( In vivo protection against soman toxicity by known inhibitors of acetylcholine synthesis in vitro.
Doukas, PH; O'Neill, JJ; Sheldon, RJ; Sterling, GH, 1988
)
"5 mg/kg, elevated the LD50 of diisopropylfluorophosphate (DFP) to a significant degree."( Protection by phenytoin and calcium channel blocking agents against the toxicity of diisopropylfluorophosphate.
Bowles, AM; Dretchen, KL; Raines, A, 1986
)
" The results indicated that mayfly larvae were very sensitive to the toxic effects of acephate, whereas larvae of the stonefly, damselfly and mosquito were much less sensitive."( Studies on the toxicity, metabolism, and anticholinesterase properties of acephate and methamidophos.
Hussain, MA; Mohamad, RB; Oloffs, PC, 1985
)
" An additive toxic effect of atropine was suggested with its combinations with TMB4, mecamylamine, and diazepam, whereas no additive toxicity occurred with combinations involving hexamethonium or benactyzine (i."( Efficacy and toxicity of drug combinations in treatment of physostigmine toxicosis.
Klemm, WR, 1983
)
" Animals were challenged with 5 x LD50 GF (233 micrograms/kg, IM) following pretreatment with pyridostigmine (0."( Acute toxicity of cyclohexylmethylphosphonofluoridate (CMPF) in rhesus monkeys: serum biochemical and hematologic changes.
Koplovitz, I; Young, GD, 1995
)
"A computer program (Q-test) was used to evaluate the combined toxic effects of nerve agent GF and its combined form with sarin (GB/GF) in mice."( Evaluation of combined toxic effects of GB/GF and efficacy of jielin injection against combined poisoning in mice.
Liang, J; Luo, C, 1997
)
" It is approximately equally toxic in the rat, mouse, and guinea-pig."( The toxicity of 2-hydroxyiminomethyl-N-methylpyridinium methanesulphonate (P2S).
DAVIES, DR; WILLEY, GL, 1958
)
" The consistently steep probit slopes of the dose-response curves for highly toxic OP compounds suggested that these compounds have a single specific mechanism of toxicity regardless of the OP compound or the species in which it was tested."( Acetylcholinesterase inhibition: does it explain the toxicity of organophosphorus compounds?
Brecht, KM; Koplovitz, I; Maxwell, DM; Sweeney, RE, 2006
)
"We sought to determine whether adverse drug reactions (ADR) from pralidoxime administration to children occur."( Pralidoxime safety and toxicity in children.
Quail, MT; Shannon, MW,
)
"7%) were identified as having a potential adverse drug reaction; all were mild."( Pralidoxime safety and toxicity in children.
Quail, MT; Shannon, MW,
)
" Our data suggest that adverse drug reactions to pralidoxime treatment in children are rare."( Pralidoxime safety and toxicity in children.
Quail, MT; Shannon, MW,
)
" Our LD50 data show that K-107, K-108 and K-113 (which strongly inhibit AChE in vitro) are in vivo markedly more toxic than all other oximes tested and can therefore only be safely administered at a low dosage which is insufficient to protect from DFP-induced mortality."( Eight new bispyridinium oximes in comparison with the conventional oximes pralidoxime and obidoxime: in vivo efficacy to protect from diisopropylfluorophosphate toxicity.
Hasan, MY; Kuca, K; Lorke, DE; Musilek, K; Nurulain, SM; Petroianu, GA, 2008
)
" Although pretreatment with atropine minimizes the adverse effect of pralidoxime reported in these models, concerns over the risks of pralidoxime in humans with carbamate poisoning continue."( Use of pralidoxime without atropine in rivastigmine (carbamate) toxicity.
Felberbaum, M; Hoffman, RS; Manini, AF; Mercurio-Zappala, M; Russell-Haders, AL, 2009
)
"2 LD50 = 896 mg/kg) were administered intravenously (iv) 30 minutes after a single intraperitoneal (ip) injection of MAL (0."( Benefit of nanocarrier of magnetic magnesium in rat malathion-induced toxicity and cardiac failure using non-invasive monitoring of electrocardiogram and blood pressure.
Abdollahi, M; Baeeri, M; Karimi, G; Mohammadi, H; Nikfar, S; Sabzevari, O; Shafiee, H, 2011
)
" The transdermal patches did not induce any adverse reactions such as erythema and edema on intact skin sites."( Acute dermal irritation, sensitization, and acute toxicity studies of a transdermal patch for prophylaxis against ({+/-}) anatoxin-a poisoning.
Banerjee, S; Chattopadhyay, P; Ghosh, A; Pathak, MP; Singh, S; Veer, V, 2013
)
" However, the individual toxic dynamics of diversified OPCs should not be overlooked and further studies with different OPCs are suggested."( Efficacy of N-Acetylcysteine, Glutathione, and Ascorbic Acid in Acute Toxicity of Paraoxon to Wistar Rats: Survival Study.
Adem, A; Kalasz, H; Nurulain, SM; Ojha, S; Shafiullah, M; Tekes, K, 2015
)
" In the ED50 study, male guinea pigs clipped of hair received 2x LD50 topical challenges of undiluted Russian VX (VR), VX, or phorate oxon (PHO) and, at the onset of cholinergic signs, IM therapy of atropine (0."( Toxicity and median effective doses of oxime therapies against percutaneous organophosphorus pesticide and nerve agent challenges in the Hartley guinea pig.
Babin, MC; Jett, DA; Platoff, GE; Snider, TH; Yeung, DT, 2016
)

Pharmacokinetics

A simple reverse-phase high-performance liquid chromatography method with diode array detection has been developed and validated for the simultaneous determination and quantification of eserine and pralidoxime chloride in rabbit plasma. One subject's data were excluded from pharmacokinetic analysis due to aberrant plasma pralid Oxime analysis.

ExcerptReference
" Plasma concentrations for both oximes were fitted to standard pharmacokinetic models using the computer program PCNONLIN."( Pharmacokinetics and pharmacodynamics of oximes in unanesthetized pigs.
Corcoran, KD; Hayward, IJ; Kaminskis, A; McCluskey, MP; Shih, ML; Stemler, FW; Stewart, JR; Tezak-Reid, TM; Wade, JV, 1991
)
" Next the relationship of plasma concentration to time was expressed in terms of a standard pharmacokinetic model."( Pharmacokinetics of pralidoxime chloride in the rat.
Clark, CR; Green, MD; Talbot, BG, 1986
)
" One subject's data were excluded from pharmacokinetic analysis due to aberrant plasma pralidoxime analysis."( Pharmacokinetics following a loading plus a continuous infusion of pralidoxime compared with the traditional short infusion regimen in human volunteers.
Goldfrank, LR; Hoffman, RS; Howland, MA; Medicis, JJ; Stork, CM, 1996
)
"In the present study, a simple reverse-phase high-performance liquid chromatography method with diode array detection has been developed and validated for the simultaneous determination and quantification of eserine and pralidoxime chloride in rabbit plasma and its application to pharmacokinetic study."( Pharmacokinetic and biodistribution study of eserine and pralidoxime chloride in rabbits following a single application of a transdermal patch.
Banerjee, S; Bhatnagar, A; Chattopadhyay, P; Ghosh, A; Veer, V, 2016
)
" To examine the mechanism, identify the transporter, and establish the actions of a transport inhibitor, we compare the pharmacokinetic parameters in a P-glycoprotein knockout mouse strain and see dramatic enhancements of short-term plasma and tissue levels."( Enhancing Target Tissue Levels and Diminishing Plasma Clearance of Ionizing Zwitterionic Antidotes in Organophosphate Exposures.
Garcia, A; Momper, JD; Radic, Z; Samskey, NM; Sepulveda, Y; Sharpless, KB; Shyong, YJ; Sit, RK; Taylor, P, 2021
)
" Compared to the published half-life of 2-PAM (less than 2 h), the lead novel oxime, Oxime 20, displayed a plasma half-life of about 5 h in both sexes of rats following intramuscular administration."( Pharmacokinetics of three novel pyridinium aldoxime acetylcholinesterase reactivators in female rats.
Backer, BS; Chambers, JE; Meek, EC; Ross, MK, 2022
)

Compound-Compound Interactions

Pridaloxime significantly improved cerebral mitochondrial complex IV-linked respiration and reduced signs of brain injury in a rodent model of acute DFP exposure. Anecdotal observations with a combination of sublingual pralidoxime and ipratropium (ProBAN) suggested that these agents in combination with nicotine gum improved quit rates.

ExcerptReference
"Atropine, in combination with 1 of 6 other drugs, was tested in mice for the ability to prevent death by an otherwise lethal dose of the cholinesterase inhibitor, physostigmine."( Efficacy and toxicity of drug combinations in treatment of physostigmine toxicosis.
Klemm, WR, 1983
)
" Anecdotal observations with a combination of sublingual pralidoxime and ipratropium (ProBAN) suggested that these agents in combination with nicotine gum improved quit rates."( Nicotine replacement combined with a novel compound (ProBAN) for smoking cessation: a pilot study.
Balon , JW; Brosky , G; Cox , G; Leigh , R; O'Shaughnessy , D; Sears , MR; Viner , NM; Walker , C; Wilson , DM,
)
"This pilot study indicated that ProBAN combined with nicotine replacement doubled the continuous sustained quit rate compared with nicotine replacement alone, with no adverse effects."( Nicotine replacement combined with a novel compound (ProBAN) for smoking cessation: a pilot study.
Balon , JW; Brosky , G; Cox , G; Leigh , R; O'Shaughnessy , D; Sears , MR; Viner , NM; Walker , C; Wilson , DM,
)
" 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."( Pharmacokinetic analysis of pralidoxime after its intramuscular injection alone or in combination with atropine-avizafone in healthy volunteers.
Abbara, C; Bardot, I; Diquet, B; Ferec, S; Lallement, G; Lelièvre, B; Rousseau, JM; Turcant, A, 2010
)
"The injection of pralidoxime combination with atropine and avizafone provided a higher pralidoxime maximal concentration than that obtained after the injection of pralidoxime alone (out of bioequivalence range), while pralidoxime AUC values were equivalent."( Pharmacokinetic analysis of pralidoxime after its intramuscular injection alone or in combination with atropine-avizafone in healthy volunteers.
Abbara, C; Bardot, I; Diquet, B; Ferec, S; Lallement, G; Lelièvre, B; Rousseau, JM; Turcant, A, 2010
)
"To observe the effect of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning."( [The influence of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning].
Gao, D; Jian, X; Sun, B; Xiao, L; Yang, L; Zhao, B; Zou, X, 2016
)
"Sodium bicarbonate combined with ulinastatin can improve the therapeutic effect and reduce complications in the treatment of acute phoxim pesticide poisoning, and have beneficial effects on the recovery of cholinesterase activity."( [The influence of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning].
Gao, D; Jian, X; Sun, B; Xiao, L; Yang, L; Zhao, B; Zou, X, 2016
)
" We demonstrate that NV354, in combination with atropine and pralidoxime therapy, significantly improved cerebral mitochondrial complex IV-linked respiration and reduced signs of brain injury in a rodent model of acute DFP exposure."( Succinate prodrugs in combination with atropine and pralidoxime protect cerebral mitochondrial function in a rodent model of acute organophosphate poisoning.
Clayman, CL; Ehinger, JK; Elmér, E; Hansson, MJ; Jang, DH; Janowska, JI; Jose, JS; Karlsson, M; Kilbaugh, TJ; McManus, MJ; Piel, S; Sheldon, M; Starr, J; Ward, JL, 2022
)

Bioavailability

ExcerptReference
" Estimates of various pharmacokinetic parameters were calculated using an open, one-compartment model: volume of distribution (Vd), maximal plasma concentration (Cmax), elimination rate constant (k10), absorption rate constant (k01), area under the curve (AUC) and clearance (CL)."( Pharmacokinetics of pralidoxime chloride in the rat.
Clark, CR; Green, MD; Talbot, BG, 1986
)
"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."( Bioavailability of diazepam after intramuscular injection of its water-soluble prodrug alone or with atropine-pralidoxime in healthy volunteers.
Abbara, C; Bardot, I; Clair, P; Comets, E; Diquet, B; Lallement, G; Rousseau, JM; Turcant, A, 2009
)
" 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."( Rapid and complete bioavailability of antidotes for organophosphorus nerve agent and cyanide poisoning in minipigs after intraosseous administration.
Blain, PG; Clutton, RE; Dunn, M; Eddleston, M; Jefferson, RD; Murray, DB; Thomas, S; Thompson, A; Vidler, DS, 2012
)
"This study showed rapid and substantial antidote bioavailability after intraosseous administration that appeared similar to that of the intravenous route."( Rapid and complete bioavailability of antidotes for organophosphorus nerve agent and cyanide poisoning in minipigs after intraosseous administration.
Blain, PG; Clutton, RE; Dunn, M; Eddleston, M; Jefferson, RD; Murray, DB; Thomas, S; Thompson, A; Vidler, DS, 2012
)
" However, bioavailability is affected by various factors ranging from the molecular weight of the drug to the mode of intranasal delivery."( Effect of administration method, animal weight and age on the intranasal delivery of drugs to the brain.
Appu, AP; Arun, P; Chembukave, B; Krishnan, JKS; Moffett, JR; Namboodiri, AMA; Puthillathu, N; Vijayakumar, N, 2017
)

Dosage Studied

Dosages of pralidoxime should be adjusted in organophosphate-poisoned humans with renal failure when using high dosage regimen. Children over 1 year of age should be given a full dose of both atropine and pralidOxime from the Mark 1 kit.

ExcerptReference
" Pretreatment of the mice with a single dose of pyridostigmine prevented the development of jitter after subsequent dosing with an organophosphate."( Protection against the effects of anticholinesterases on the latencies of action potentials in mouse skeletal muscles.
Bamforth, JP; Das, SK; Ferry, CB; Kelly, SS, 1992
)
" After administering 1500 mg/kg of FNT orally to mice, the life-saving effect was studied from the changes in mortality due to variation of PAM route, dosage and number of administrations."( [Experimental studies on the efficacy of PAM against sumithion poisoning].
Sekita, K, 1992
)
" This behavioral toxicity was lessened by reducing ATR dosage from 128 to 64 mg/kg, but 2-PAM dosage did not influence the behavioral toxicity of the treatment combinations within the range of dosages studied."( Protection from lethality and behavioral incapacitation resulting from intoxication by soman (pinacolyl methylphosphonofluoridate) and treatment with atropine sulfate and 2-PAM chloride in the guinea pig, cavia porcellus.
Mays, MZ; Murrow, ML; Romano, JA; Terry, MR, 1991
)
" Poisindex, a widely used poisoning treatment resource, recommends dosing pralidoxime chloride as an intermittent iv infusion every 8-12 hours, whereas other authors have used continuous iv infusion with good results."( Therapeutic dosing of pralidoxime chloride.
Greenwood, RB; Thompson, DF; Thompson, GD; Trammel, HL,
)
" comparison of routes of administration, dose-response relationships, and time to effect."( In vivo protection against soman toxicity by known inhibitors of acetylcholine synthesis in vitro.
Doukas, PH; O'Neill, JJ; Sheldon, RJ; Sterling, GH, 1988
)
" In both species at 30 min after im injection of Py and Ph, a linear relationship was found between percentage of whole blood AChE inhibition and ln dosage of carbamate."( Relationship between reversible acetylcholinesterase inhibition and efficacy against soman lethality.
Anderson, DR; Harris, LW; Lennox, WJ; Talbot, BG, 1985
)
" 4 The kinetic data of reactivation established for diethylphosphoryl-AChE of human red cells indicate that the usually recommended dosage to attain a plasma concentration of 4 micrograms/ml does not permit exploitation of the full therapeutic potential of the oximes, in particular of pralidoxime."( Reappraisal of indications and limitations of oxime therapy in organophosphate poisoning.
Bäcker, M; Eyer, P; Klimmek, R; Mast, U; Szinicz, L; Thiermann, H; Worek, F, 1997
)
" At a dosage of 100 mg/kg BW, atropine was mildly toxic and at 200 mg/kg 2-PAM was severely toxic (but not lethal), whereas at dosages of 50 and 100 mg/kg BW, respectively, the antidotes were at their most effective."( New treatment regimens in organophosphate (diazinon) and carbamate (methomyl) insecticide-induced toxicosis in fowl.
Bellaiche, M; Ershov, E; Hanji, V; Shlosberg, A, 1997
)
"The plasma levels, disposition kinetics and a dosage regimen for pralidoxime (2-PAM) were investigated in male buffalo calves following single intramuscular administration (15 or 30 mg/kg)."( Intramuscular kinetics and dosage regimens for pralidoxime in buffalo calves (Bubalus bubalis).
Malik, JK; Srivastava, AK, 2001
)
" Rats were dosed with 4 different doses of dimehypo: 1/16, 1/8, 1/4 and 1/2 of LD50 respectively(the LD50 of dimehypo is 342 mg/kg)."( [The activity of blood cholinesterase in rats exposed to dimethypo after drug intervention].
Chen, Y; Lu, A; Shen, X; Wan, W; Xu, M; Zou, H, 2002
)
" Although in theory this could mislead clinicians into assuming an efficacious therapy, this is unlikely to occur in vivo under normal pralidoxime dosing conditions."( Enzyme reactivator treatment in organophosphate exposure: clinical relevance of thiocholinesteratic activity of pralidoxime.
Ewald, V; Maleck, WH; Missler, A; Petroianu, GA; Thyes, C; Zuleger, K,
)
" Therapeutic dosage regimens need to be clarified and availability of a reliable method for plasma pralidoxime quantification would be helpful in this process."( Measurement of serum pralidoxime methylsulfate (Contrathion) by high-performance liquid chromatography with electrochemical detection.
Baud, F; Borron, SW; Bousquet, B; Gourmel, B; Houzé, P; Scherninski, F, 2005
)
" Varying dosage schedules of pralidoxime or obidoxime were used."( Oxime therapy and outcomes in human organophosphate poisoning: an evaluation using meta-analytic techniques.
Graham, P; Moran, JL; Peter, JV, 2006
)
" Therefore, the Regional Emergency Medical Advisory Committee of New York City and the Fire Department, City of New York, Bureau of Emergency Medical Services, in collaboration with the Center for Pediatric Emergency Medicine of the New York University School of Medicine and the Bellevue Hospital Center, have developed a pediatric nerve agent antidote dosing schedule that addresses these considerations."( Pediatric nerve agent poisoning: medical and operational considerations for emergency medical services in a large American city.
Asaeda, G; Bove, J; Cherson, A; Cooper, A; Curran, J; Foltin, G; Gonzalez, D; Kaufman, B; Langsam, Y; Marshall, L; Tunik, M; van Amerongen, R, 2006
)
" Mortality dose-response curves for several OP compounds (i."( Acetylcholinesterase inhibition: does it explain the toxicity of organophosphorus compounds?
Brecht, KM; Koplovitz, I; Maxwell, DM; Sweeney, RE, 2006
)
"5 mg) or Mark 1 kits (2 mg), while children over 1 year of age should be given a full dose of both atropine and pralidoxime from the Mark 1 kit when more accurate weight-based dosing of antidotes is impossible."( Antidotes for nerve agent poisoning: should we differentiate children from adults?
Baker, MD, 2007
)
" Our LD50 data show that K-107, K-108 and K-113 (which strongly inhibit AChE in vitro) are in vivo markedly more toxic than all other oximes tested and can therefore only be safely administered at a low dosage which is insufficient to protect from DFP-induced mortality."( Eight new bispyridinium oximes in comparison with the conventional oximes pralidoxime and obidoxime: in vivo efficacy to protect from diisopropylfluorophosphate toxicity.
Hasan, MY; Kuca, K; Lorke, DE; Musilek, K; Nurulain, SM; Petroianu, GA, 2008
)
" These results suggest that dosages of pralidoxime should be adjusted in organophosphate-poisoned humans with renal failure when using high dosage regimen of pralidoxime."( Acute renal failure alters the kinetics of pralidoxime in rats.
Baud, FJ; Debray, M; Houzé, P; Kayouka, M; Risède, P, 2009
)
" Rats received DFP intraperitoneally in a dosage of 6, 8, or 10 micromol/rat and immediately thereafter intraperitoneal injections of K-27, K-48, pralidoxime, obidoxime, trimedoxime, methoxime, or HI-6."( Efficacy of two new asymmetric bispyridinium oximes (K-27 and K-48) in rats exposed to diisopropylfluorophosphate: comparison with pralidoxime, obidoxime, trimedoxime, methoxime, and HI-6.
Hasan, MY; Kuca, K; Lorke, DE; Nurulain, SM; Petroianu, GA; Schmitt, A, 2009
)
" Thus, the data presented strongly support the administration of appropriately dosed oximes, preferably obidoxime, in paraoxon-poisoned patients to restore paraoxon-impaired muscle force."( Muscle force and acetylcholinesterase activity in mouse hemidiaphragms exposed to paraoxon and treated by oximes in vitro.
Eyer, P; Thiermann, H; Worek, F, 2010
)
" However, appropriate dosing and efficacy remains a matter of discussion requiring experimental data."( Quantification of pralidoxime (2-PAM) in urine by ion pair chromatography-diode array detection: application to in vivo samples from minipig.
Eddie Clutton, R; Eddleston, M; John, H; Thiermann, H; Worek, F,
)
" Because 2-PAM is often dosed empirically, clinical improvement does not guarantee pharmacological stability."( Preparing for chemical terrorism: a study of the stability of expired pralidoxime (2-PAM).
Bouchard, N; Goldfrank, L; Hoffman, RS; Mercurio-Zappala, M; Ravikumar, P, 2012
)
" It could be also used with reliability for the determination of the drug in other pharmaceutical dosage forms."( Development and validation of a reverse phase liquid chromatography method for the simultaneous quantification of eserine and pralidoxime chloride in drugs-in-adhesive matrix type transdermal patches.
Banerjee, S; Chattopadhyay, P; Ghosh, A; Kaity, S; Veer, V, 2013
)
" Patients admitted to the hospital for organophosphate poisoning were divided into 2 groups with different therapeutic regimens: group A was administered a repeated pulse intramuscular injection of pralidoxime chloride, and group B received the same initial dosage of atropine and pralidoxime chloride, but pralidoxime chloride intravenous therapy was administered for only 3 days, regardless of the length of atropine therapy."( Repeated pulse intramuscular injection of pralidoxime chloride in severe acute organophosphorus pesticide poisoning.
Hu, J; Tang, X; Wang, R; Xie, H; Zhao, W, 2013
)
" However, further trials are needed to explore different dosing regimens of pralidoxime in order to determine its efficacy in OP poisoning."( Efficacy of pralidoxime in organophosphorus poisoning: revisiting the controversy in Indian setting.
Banerjee, I; Roy, AS; Tripathi, SK,
)
" The total atropine dosage, total pralidoxime methylchloride dosage and hospitalization days were better than the conventional treatment group, and the differences were statistically significant (P<0."( [The influence of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning].
Gao, D; Jian, X; Sun, B; Xiao, L; Yang, L; Zhao, B; Zou, X, 2016
)
" In considering dosing requirements for oxime antidotes in OP exposures that inactivate AChE, clearance of proton ionizable, zwitterionic antidotes is rapid and proceeds with largely the parent antidotal compound being cleared by renal transporters."( Enhancing Target Tissue Levels and Diminishing Plasma Clearance of Ionizing Zwitterionic Antidotes in Organophosphate Exposures.
Garcia, A; Momper, JD; Radic, Z; Samskey, NM; Sepulveda, Y; Sharpless, KB; Shyong, YJ; Sit, RK; Taylor, P, 2021
)
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Roles (4)

RoleDescription
cholinergic drugAny drug used for its actions on cholinergic systems. Included here are agonists and antagonists, drugs that affect the life cycle of acetylcholine, and drugs that affect the survival of cholinergic neurons.
cholinesterase reactivatorA drug used to reverse the inactivation of cholinesterase caused by organophosphates or sulfonates.
antidote to organophosphate poisoningA role borne by a molecule that acts to counteract or neutralise the deleterious effects of organophosphates or acetylcholinesterase inhibitors (nerve agents).
antidote to sarin poisoningA role borne by a molecule that acts to counteract or neutralise the nerve agent sarin.
[role information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Drug Classes (1)

ClassDescription
pyridinium ion
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (2)

Inhibition Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
CholinesteraseHomo sapiens (human)IC50 (µMol)878.00000.00001.559910.0000AID1802986
AcetylcholinesteraseHomo sapiens (human)IC50 (µMol)878.00000.00000.933210.0000AID1802986
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Biological Processes (25)

Processvia Protein(s)Taxonomy
xenobiotic metabolic processCholinesteraseHomo sapiens (human)
learningCholinesteraseHomo sapiens (human)
negative regulation of cell population proliferationCholinesteraseHomo sapiens (human)
neuroblast differentiationCholinesteraseHomo sapiens (human)
peptide hormone processingCholinesteraseHomo sapiens (human)
response to alkaloidCholinesteraseHomo sapiens (human)
cocaine metabolic processCholinesteraseHomo sapiens (human)
negative regulation of synaptic transmissionCholinesteraseHomo sapiens (human)
response to glucocorticoidCholinesteraseHomo sapiens (human)
response to folic acidCholinesteraseHomo sapiens (human)
choline metabolic processCholinesteraseHomo sapiens (human)
acetylcholine catabolic processCholinesteraseHomo sapiens (human)
acetylcholine catabolic process in synaptic cleftAcetylcholinesteraseHomo sapiens (human)
regulation of receptor recyclingAcetylcholinesteraseHomo sapiens (human)
osteoblast developmentAcetylcholinesteraseHomo sapiens (human)
acetylcholine catabolic processAcetylcholinesteraseHomo sapiens (human)
cell adhesionAcetylcholinesteraseHomo sapiens (human)
nervous system developmentAcetylcholinesteraseHomo sapiens (human)
synapse assemblyAcetylcholinesteraseHomo sapiens (human)
receptor internalizationAcetylcholinesteraseHomo sapiens (human)
negative regulation of synaptic transmission, cholinergicAcetylcholinesteraseHomo sapiens (human)
amyloid precursor protein metabolic processAcetylcholinesteraseHomo sapiens (human)
positive regulation of protein secretionAcetylcholinesteraseHomo sapiens (human)
retina development in camera-type eyeAcetylcholinesteraseHomo sapiens (human)
acetylcholine receptor signaling pathwayAcetylcholinesteraseHomo sapiens (human)
positive regulation of cold-induced thermogenesisAcetylcholinesteraseHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Molecular Functions (15)

Processvia Protein(s)Taxonomy
amyloid-beta bindingCholinesteraseHomo sapiens (human)
catalytic activityCholinesteraseHomo sapiens (human)
acetylcholinesterase activityCholinesteraseHomo sapiens (human)
cholinesterase activityCholinesteraseHomo sapiens (human)
protein bindingCholinesteraseHomo sapiens (human)
hydrolase activity, acting on ester bondsCholinesteraseHomo sapiens (human)
enzyme bindingCholinesteraseHomo sapiens (human)
choline bindingCholinesteraseHomo sapiens (human)
identical protein bindingCholinesteraseHomo sapiens (human)
amyloid-beta bindingAcetylcholinesteraseHomo sapiens (human)
acetylcholinesterase activityAcetylcholinesteraseHomo sapiens (human)
cholinesterase activityAcetylcholinesteraseHomo sapiens (human)
protein bindingAcetylcholinesteraseHomo sapiens (human)
collagen bindingAcetylcholinesteraseHomo sapiens (human)
hydrolase activityAcetylcholinesteraseHomo sapiens (human)
serine hydrolase activityAcetylcholinesteraseHomo sapiens (human)
acetylcholine bindingAcetylcholinesteraseHomo sapiens (human)
protein homodimerization activityAcetylcholinesteraseHomo sapiens (human)
laminin bindingAcetylcholinesteraseHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Ceullar Components (16)

Processvia Protein(s)Taxonomy
extracellular regionCholinesteraseHomo sapiens (human)
nuclear envelope lumenCholinesteraseHomo sapiens (human)
endoplasmic reticulum lumenCholinesteraseHomo sapiens (human)
blood microparticleCholinesteraseHomo sapiens (human)
plasma membraneCholinesteraseHomo sapiens (human)
extracellular spaceCholinesteraseHomo sapiens (human)
extracellular regionAcetylcholinesteraseHomo sapiens (human)
basement membraneAcetylcholinesteraseHomo sapiens (human)
extracellular spaceAcetylcholinesteraseHomo sapiens (human)
nucleusAcetylcholinesteraseHomo sapiens (human)
Golgi apparatusAcetylcholinesteraseHomo sapiens (human)
plasma membraneAcetylcholinesteraseHomo sapiens (human)
cell surfaceAcetylcholinesteraseHomo sapiens (human)
membraneAcetylcholinesteraseHomo sapiens (human)
neuromuscular junctionAcetylcholinesteraseHomo sapiens (human)
synaptic cleftAcetylcholinesteraseHomo sapiens (human)
synapseAcetylcholinesteraseHomo sapiens (human)
perinuclear region of cytoplasmAcetylcholinesteraseHomo sapiens (human)
side of membraneAcetylcholinesteraseHomo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (1)

Assay IDTitleYearJournalArticle
AID1802986In Vitro Assay from Article 10.3109/14756366.2010.496362: \\The preparation, in vitro screening and molecular docking of symmetrical bisquaternary cholinesterase inhibitors containing a but-(2E)-en-1,4-diyl connecting linkage.\\2011Journal of enzyme inhibition and medicinal chemistry, Apr, Volume: 26, Issue:2
The preparation, in vitro screening and molecular docking of symmetrical bisquaternary cholinesterase inhibitors containing a but-(2E)-en-1,4-diyl connecting linkage.
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (609)

TimeframeStudies, This Drug (%)All Drugs %
pre-1990162 (26.60)18.7374
1990's111 (18.23)18.2507
2000's160 (26.27)29.6817
2010's142 (23.32)24.3611
2020's34 (5.58)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials28 (4.26%)5.53%
Reviews34 (5.17%)6.00%
Case Studies85 (12.92%)4.05%
Observational1 (0.15%)0.25%
Other510 (77.51%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (4)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Effect of Adding Nebulized Salbutamol to Intravenous Atropine and Oxygen During Resuscitation of OP Pesticide Poisoned Patients[NCT02160548]Phase 375 participants (Actual)Interventional2015-04-30Completed
Study Effect of WHO Recommended Dose of Pralidoxime in the Treatment of Organophosphorus Poisoning[NCT02040350]Phase 1100 participants (Actual)Interventional2012-04-30Completed
Effectiveness of High Dose Pralidoxime in the Treatment of Organophosphorus Pesticide Poisoning - a Randomised Controlled Trial[NCT00333944]200 participants Interventional2000-05-31Completed
Outcome of OPC Poisoning Patients Between Two Treatment Groups One With Atropine Plus Pralidoxime and Other With Only Atropine[NCT06111352]Phase 296 participants (Anticipated)Interventional2023-11-30Recruiting
[information is prepared from clinicaltrials.gov, extracted Sep-2024]