Why Pralidoxime is CONTRAINDICATED in Carbamate Poisoning?

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Video Summary:
For pralidoxime to work the anionic site of the enzyme must be free. In organophosphate poisoning, it is free. So pralidoxime can bind to this site, and then take away the organophosphate molecule. So the benefit of reactivation of enzyme is present in organophosphate poisoning. But in the case of carbamate poisoning, the anionic site is occupied. And pralidoxime cannot work on such enzymes. So there is no reactivation of the carbamylated enzyme. Small loss due to weak anticholinesterase activity is present in both cases. The final answer is, pralidoxime is indicated in organophosphate poisoning because the benefit is much more than the loss. But it's contraindicated in carbamate poisoning because there is no benefit in form of reactivation of enzyme. There's only loss.
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DISCLAIMER: This video is for education purpose only. Although every effort is made to ensure accuracy of material, viewer should refer to the appropriate regulatory body/authorised websites, guidelines and other suitable sources of information as deemed relevant and applicable. In view of possibility of human error or changes in medical science, any person or organization involved in preparation of this work accepts no responsibility for any errors or omissions or results obtained from use of information in this video.

[@shubhamsharma3366]

Simple and clear explanation I've ever seen in my life. Thank you

[@NonstopNeuron]

Great to hear!

[@anaspiringbud2908]

This is one of the best videos i have watched by far of this topic. Keep growing!

[@NonstopNeuron]

Thanks a ton

[@apronaddicted8652]

Crystal clear 🎉❤

[@nivetharajasekaran]

Beautifully explained. Thank you.

[@dr.mukulkanojia]

Was really useful.Thank you so much 🙏🏻

[@anwyeshabhattacharya432]

Thank you so much..best and simplest explanation

[@Amruth_sk]

wow! soooo clear and simple!!!

[@Medico0521]

The best explanation ever 🔥🔥Thank you so muchh

[@shubhamgawande9776]

Amazing explanation

[@gagandalal5233]

Thank you so much 🙌🏻

[@user-ec1uy8jl3i]

Sooooo helpful ❤❤❤❤❤❤ thank you so much ❤

[@user-ko8fm1ly6g]

Thank you very much

[@tarikanowar6354]

Very effective explanation

[@logicalmind_1]

that was just amazing

[@thesimplewonders1918]

Clean and clear

[@saishivareddy4034]

Excellent

[@thegoalvoyage5485]

beautiful thx.!!!!!!!!!!!!!!!!!!!!!!

[@dda2129]

Thanks more...
Who about the organophosphate is inactive for pralidoxime after aging? (Is it bind with anionic site as carbamale after aging or in other mechanism )

[@themedicodiary2783]

Very good explanation ... thank you 😊 this video make me understand this concept clearly

[@NonstopNeuron]

Glad to hear that

[@aamirkhantma8854]

Great Great Great concept. ❤❤❤u r great

[@payalnayak2176]

Great explanation.

[@NonstopNeuron]

Thank you

[@doccy-lucky]

Thank you sir

[@aakashkamat2658]

Thank you sir, your efforts in making of this video are appreciated 🙏❤! Namaskara.

[@NonstopNeuron]

Thank you 😊

[@christianafriyie6937]

Great!

[@darshanbhirud3354]

Thank you sir this video made me fearless

[@NonstopNeuron]

Thank you Darshan. Please share the videos with your collogues and friends too. 😊

[@the_meme_spammer1]

Then how to treat muscular paralysis because we cant use atropine as it has no effect on Nm receptor??

[@venkatanarasimhanb792]

Nailed itt

[@SahilKumar-if5zn]

Nice explanation bhai..
Plz also make videos regarding other subjects like radiogy..

[@NonstopNeuron]

We are currently focusing on pharmacology and physiology. But yes, in long term we are planning to go for all the subjects. You can support by sharing the videos. Thank you.!

[@xinformatics]

04:37 should be "useful in organophosphate poisoning" right?

[@NonstopNeuron]

Oh yes.

[@tarikanowar6354]

Thnq sir

[@NonstopNeuron]

Most welcome 😊

[@MrAbeyy]

What about aging of the enzyme??

[@nishantsen6820]

Sir weak means Vander wall force reversible
Strong by covalent bond irreversible

[@chantellekirk2993]

Would any quaternary ammonium compound do what is described in video or just pralidoxime (a quaternary ammonium)?

[@JEGGinSD]

Pralidoxime contains a “warhead” needed for inactivation of the organophosphate as well as a cationic group required for interaction with the anionic group. It is possible that other molecules containing cationic groups would interact with the receptor, but in the absence of the warhead group, they will not cleave the bond between the phosphoryl group and the receptor.
Pralidomide is unique because it contains both groups, but for various reasons, it has to be administered at fairly high doses. There are related compounds that have been evaluated, but Pralidomide seems to be one of the first choices for treatment of organophosphate poisoning

[@aymenabid848]

sir lah yrhem lik lwalidin ela had l video

[@aliatar492]

Hi
Do u have vedio on "clinical biochemstry"
I can to pay for this

[@NonstopNeuron]

no... channel is all we have so far.

[@muqtarjamaegal6071]

The only thing remaining is to study chemical formula biochemistery of this drugs enzymes

[@NonstopNeuron]

It's needed in very few cases only.

[@MrERDoc]

Thanks for your effort and clear presentation. However, the contraindication to Pralidoxime in Carbamate poisoning is questionable, as far as I know, it applies only to carbaryl. Another argument to give a mixture of Atropine and Pralidoxime in case of a mass casualty event (we stock autoinjectors) is the fact that the benefit of giving Pralidoxime in this scenario outweighs the risks. That means the provider is confronted with an organophosphate toxidrome without knowledge of the exact content of the culprit. But that said, I can only follow the other comments: this is one of the best explanations on the subject I've ever seen - Thanks!

[@NonstopNeuron]

Yup... Valid points... Thanks

[@the_meme_spammer1]

I think your concepts are weak..