PAM-pralidoxime
OP organophosphate
C carbamates
E Estericsite
A anionic site
ache Acetyl Choline Esterase
ENZYME REACTIVATORS like PRALIDOXIME can be used in OP POISONING but they are CONTRAINDICATED in CARBAMATE POISONING
The site on which oximes bind and reactivate the enzyme - ANIONIC SITE is occupied by carbamates (right side of fig)
Where as it is free in organophosphate poisoning (left side of fig)
OP - ESTERIC SITE ONLY
C - ESTERIC + ANIONIC
And also OXIMES also has weak ache inhibitory action
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