Obidoxime

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Overview

Skeletal structure of Obidoxime

Obidoxime is a chemical compound used as an oxime in the treatment of organophosphate poisoning. It is a member of the oxime family, which are compounds that can reactivate acetylcholinesterase that has been inhibited by organophosphates.

Mechanism of Action

Obidoxime works by binding to the acetylcholinesterase enzyme that has been phosphorylated by an organophosphate. The oxime group in Obidoxime has a high affinity for the phosphorus atom in the organophosphate, allowing it to cleave the bond between the enzyme and the organophosphate, thereby reactivating the enzyme. This process restores the normal function of acetylcholinesterase, which is to break down acetylcholine in the synaptic cleft.

Clinical Use

Obidoxime is used in conjunction with atropine in the treatment of organophosphate poisoning. While atropine acts as an antimuscarinic agent to counteract the effects of excess acetylcholine, Obidoxime works to restore the activity of acetylcholinesterase. This dual approach is critical in managing the symptoms of organophosphate poisoning, which include muscle weakness, respiratory distress, and seizures.

Pharmacokinetics

Obidoxime is typically administered intravenously due to its poor oral bioavailability. Once in the bloodstream, it is distributed throughout the body and can cross the blood-brain barrier to some extent, allowing it to act on central nervous system acetylcholinesterase. The compound is metabolized in the liver and excreted primarily through the kidneys.

Safety and Side Effects

The use of Obidoxime can be associated with several side effects, including nausea, vomiting, dizziness, and headache. In some cases, it may cause hypertension or tachycardia. It is important to monitor patients closely during treatment to manage any adverse effects that may arise.

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Contributors: Prab R. Tumpati, MD