Nicotinic effects organophosphate nerve agents

A. Oximes are used to treat poisoning caused by cholinesterase inhibitor insecticides and nerve agents, ie, organophosphates, mixtures of organophospho-ms and carbamate insecticides, or pure carbamate insecticide intoxication with nicotinic-associated symptoms. Because of its low toxicity, possible ineffectiveness if treatment is delayed until after the cholinesterase enzyme has aged, ability to reverse nicotinic as well as muscarinic effects, and ability to reduce atropine requirements, pralidoxime should be used early and empirically for suspected cholinesterase inhibitor poisoning. 

Nerve agents are organophosphates (OPs). Acute exposure to OPs can cause muscarinic, nicotinic, and CNS signs. Muscarinic effects include salivation, lac-rimation, urination, dyspnea, diarrhea, and emesis (SLUDDE), along with miosis, bradycardia, hypotension, and bronchoconstriction. Nicotinic effects include... 

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