The effect of pralidoxime iodide
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
Pralidoxime iodide works by reactivating cholinesterase, blocking muscarinic symptoms, relieving nicotinic symptoms, preventing the continued action of toxins, and assisting in improving respiratory depression. It is a specific antidote for organophosphate pesticide poisoning and should be used early and according to standard guidelines. If symptoms suggestive of organophosphate poisoning—such as dizziness, salivation, and muscle fasciculations—occur, immediate medical attention is recommended.
Pralidoxime iodide exerts its effects by reactivating cholinesterase, blocking muscarinic symptoms, alleviating nicotinic symptoms, preventing continued toxin action, and assisting in the improvement of respiratory depression. It is a specific antidote for organophosphate pesticide poisoning and should be used early and according to standard protocols. If symptoms suggestive of organophosphate poisoning—such as dizziness, salivation, or muscle fasciculations—occur, immediate medical attention is recommended.
1. Reactivation of cholinesterase: Organophosphates inhibit cholinesterase activity. Pralidoxime iodide binds to phosphorylated cholinesterase, restoring its enzymatic activity, thereby reducing the accumulation of acetylcholine in the body and alleviating poisoning symptoms at their source.
2. Blocking muscarinic symptoms: It reduces excessive acetylcholine-induced muscarinic manifestations such as salivation, sweating, miosis, and dyspnea, and improves increased respiratory secretions.
3. Alleviating nicotinic symptoms: It effectively reduces nicotinic symptoms such as muscle tremors, convulsions, and muscle weakness, particularly improving the risk of respiratory muscle paralysis and maintaining stable respiratory function.
4. Preventing sustained toxin effects: By binding to unbound organophosphates in the body, it forms non-toxic complexes that are excreted from the body, reducing further damage to organs and lowering the risk of worsening poisoning.
5. Assisting in improvement of respiratory depression: For respiratory center depression caused by organophosphate poisoning, pralidoxime helps improve ventilation function following cholinesterase reactivation, buying time for subsequent treatments.
During treatment, close monitoring of consciousness, respiration, and muscle fasciculations is essential. Airway patency must be maintained, fluid therapy should be administered to maintain water and electrolyte balance, concomitant use with alkaline drugs should be avoided, and dosage guidelines must be strictly followed to minimize adverse reactions.
