Caramiphen edisylate: an optimal antidote against organophosphate poisoning.

Abstract

Potent cholinesterase inhibitors such as sarin, induce an array of harmful effects including hypersecretion, convulsions and ultimately death. Surviving subjects demonstrate damage in specific brain regions that lead to cognitive and neurological dysfunctions. An early accumulation of acetylcholine in the synaptic clefts was suggested as the trigger of a sequence of neurochemical events such as an excessive outpour of glutamate and activation of its receptors. Indeed, alterations in NMDA and AMPA central receptors' densities were detected in brains of poisoned animals. Attempts to improve the current cholinergic-based treatment by adding potent anticonvulsants or antiglutamatergic drugs produced unsatisfactory results. In light of recent events in Syria and the probability of various scenarios of military or terrorist attacks involving organophosphate (OP) nerve agent, research should focus on finding markedly improved countermeasures. Caramiphen, an antimuscarinic drug with antiglutamatergic and GABAergic facilitating properties, was evaluated in a wide range of animals and experimental protocols against OP poisoning. Its remarkable efficacy against OP exposure was established both in prophylactic and post-exposure therapies in both small and large animals. The present review will highlight the outstanding neuroprotective effect of caramiphen as the optimal candidate for the treatment of OP-exposed subjects.

• Authors: Lily Raveh, Arik Eisenkraft, Ben Avi Weissman
• Journal: Toxicology (Toxicology) Vol. 325 Pg. 115-24 (Nov 05 2014) ISSN: 1879-3185 [Electronic] Ireland
• PMID: 25201353 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Antidotes
• Chemical Warfare Agents
• Cholinesterase Inhibitors
• Cyclopentanes
• Neuroprotective Agents
• caramiphen
• Acetylcholine

Topics

• Acetylcholine (metabolism)
• Animals
• Antidotes (adverse effects, pharmacokinetics, therapeutic use)
• Brain (drug effects, metabolism, physiopathology)
• Chemical Warfare Agents (poisoning)
• Cholinesterase Inhibitors (poisoning)
• Cyclopentanes (adverse effects, pharmacokinetics, therapeutic use)
• Humans
• Neuroprotective Agents (adverse effects, pharmacokinetics, therapeutic use)
• Organophosphate Poisoning (drug therapy, etiology, metabolism, physiopathology)