AIMS: Organophosphates (OPCs), useful agents as pesticides, also represent a serious health hazard. Standard therapy with atropine and established oxime-type enzyme reactivators is unsatisfactory. Experimental data indicate that superior therapeutic results can be obtained when reversible cholinesterase inhibitors are administered before OPC exposure. Comparing the protective efficacy of five such cholinesterase inhibitors (physostigmine, pyridostigmine, ranitidine, tacrine, or K-27), we observed best protection for the experimental oxime K-27. The present study was undertaken in order to determine if additional administration of K-27 immediately after OPC (paraoxon) exposure can improve the outcome. METHODS: Therapeutic efficacy was assessed in rats by determining the relative risk of death (RR) by Cox survival analysis over a period of 48 h. Animals that received only pretreatment and paraoxon were compared with those that had received pretreatment and paraoxon followed by K-27 immediately after paraoxon exposure. RESULTS: Best protection from paraoxon-induced mortality was observed after pretreatment with physostigmine (RR = 0.30) and K-27 (RR = 0.34). Both substances were significantly more efficacious than tacrine (RR = 0.67), ranitidine (RR = 0.72), and pyridostigmine (RR = 0.76), which were less efficacious but still significantly reduced the RR compared to the no-treatment group (paraoxon only). Additional administration of K-27 immediately after paraoxon exposure (posttreatment) did not further reduce mortality. Statistical analysis between pretreatment before paraoxon exposure alone and pretreatment plus K-27 posttreatment did not show any significant difference for any of the pretreatment regimens. CONCLUSIONS: Best outcome is achieved if physostigmine or K-27 are administered prophylactically before exposure to sublethal paraoxon dosages. Therapeutic outcome is not further improved by additional oxime therapy immediately thereafter.

• Klíčová slova
• carbamates, cholinesterase, cox analysis, organophosphate, oximes, paraoxon, pretreatment, prophylaxis, rat,
• MeSH
• analýza přežití MeSH
• cholinesterasové inhibitory aplikace a dávkování   toxicita   MeSH
• fysostigmin aplikace a dávkování   chemie   MeSH
• krysa rodu Rattus MeSH
• organofosfáty toxicita   MeSH
• oximy aplikace a dávkování   chemie   MeSH
• paraoxon chemie   toxicita   MeSH
• postexpoziční profylaxe MeSH
• potkani Wistar MeSH
• preexpoziční profylaxe MeSH
• proporcionální rizikové modely MeSH
• pyridostigmin-bromid aplikace a dávkování   chemie   MeSH
• ranitidin chemie   farmakologie   MeSH
• reaktivátory cholinesterasy farmakologie   MeSH
• takrin aplikace a dávkování   chemie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• cholinesterasové inhibitory MeSH
• fysostigmin MeSH
• organofosfáty MeSH
• oximy MeSH
• paraoxon MeSH
• pyridostigmin-bromid MeSH
• ranitidin MeSH
• reaktivátory cholinesterasy MeSH
• takrin MeSH