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[edit] Antidotes?
Why doesn't the article mention pralidoxime, diezepan, or norepinephrine as potential remedies for the effects of acetylcholinesterase inhibitors? - 2-16 15:03, 30 May 2007 (UTC)
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- Pralidoxime and similar oxime acetylcholinesterase reactivators (the "golden standard" of these beeing now asoxime) are useful only in serious life-threating intoxications by some organophosphates (e.g. parathion, or NA's sarin or VX); they are less to not at all useful in soman (GD) intoxications, and actually contraindicated in carbamate intoxications (by carbaryl, carbofurane, bendiocarb or neostigmine), because, upon decarbamoylation of the blocked enzyme, oxime carbamates, that are more toxic than the actual parent noxae (i.e. the carabamate poison) forms; by "diezepan", I assume, you ment diazepam, which is indicated for symptomatic reversal of muscle fasciculations and seizures, as well as for calming the poisoned victim down and improve outcome in severe NCWA intoxications; noradrenaline is even of lower relevance, since it is only a symptomatic treatment of circulatory collapse, which is not a core symptom of AChEI intoxication; the only real "advisable" antidote for all AChEIs is atropine, given by i.v. titration. It is the only agent, that does help in all AChEI intoxications (though the most severe intoxications are often lethal despite high-dose atropine), regardless of their severity or casual noxis, i.e. one could not make a manifest AChEI intoxication worse by administration of atropine, as opposed to e.g. oximes. However, this article deals not so much with AChEI toxicology, it's only a brief summary of mechanisms and agents; the respective articles nerve agent and insecticide provide specific information about causal and symptomatic treatment of intoxications.--84.163.96.19 20:25, 29 September 2007 (UTC)
