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Trimedoxime bromide

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Chemical compound Pharmaceutical compound

Trimedoxime bromide
Clinical data

Routes of administration	Intramuscular injection
ATC code	None
Legal status
Legal status	Experimental; in military use
Pharmacokinetic data
Elimination half-life	2 hours (mean)
Identifiers
IUPAC name 1,1′-propane-1,3-diylbis{4-pyridinium} dibromide
CAS Number	56-97-3
PubChem CID	5359236
ChemSpider	4514238
UNII	ED0GXI9825
CompTox Dashboard (EPA)	DTXSID101036063
ECHA InfoCard	100.000.276
Chemical and physical data
Formula	C₁₅H₁₈Br₂N₄O₂
Molar mass	446.143 g·mol

Trimedoxime bromide (INN), also known as dipyroxime or TMB-4, is an oxime used in the treatment of organophosphate poisoning It is chemically related to asoxime, pralidoxime, and obidoxime.

References

Dhuguru J, Zviagin E, Skouta R (January 2022). "FDA-Approved Oximes and Their Significance in Medicinal Chemistry". Pharmaceuticals. 15 (1). Basel, Switzerland: 66. doi:10.3390/ph15010066. PMC 8779982. PMID 35056123.
Gupta R, Parmar M (2022). "Pralidoxime". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 32644334.

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Antidotes (V03AB)

Alcohol intoxication	Metadoxine Thiamine
Barbiturate overdose	Bemegride Ethamivan
Benzodiazepine overdose	Cyprodenate Flumazenil
GHB overdose	Physostigmine SCH-50911
Nerve agent / Organophosphate poisoning	Atropine Biperiden Diazepam Oximes Obidoxime Pralidoxime see also: Cholinesterase
Opioid overdose	Diprenorphine Doxapram Nalmefene Nalorphine Naloxone Naltrexone
Reversal of neuromuscular blockade	Sugammadex

Circulatory
system

Beta blocker	Glucagon
Digoxin toxicity	Digoxin immune fab
Anticoagulants	against direct Xa inhibitors (Andexanet alfa) against heparin (Protamine)

Other

Arsenic poisoning	Dimercaprol Succimer
Cyanide poisoning	4-Dimethylaminophenol Hydroxocobalamin nitrite Amyl nitrite Sodium nitrite Sodium thiosulfate
Hydrofluoric acid	Calcium gluconate
Methanol / Ethylene glycol poisoning	Primary alcohols: Ethanol Fomepizole
Paracetamol toxicity (Acetaminophen)	Acetylcysteine Glutathione Methionine
Toxic metals (cadmium lead mercury thallium)	Dimercaprol Edetates Prussian blue
Other	iodine-131 Potassium iodide Methylthioninium chloride oxidizing agent Potassium permanganate Prednisolone/promethazine

WHO-EM
Withdrawn from market
Clinical trials:
- Phase III
- Never to phase III

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Acetylcholine metabolism and transport modulators

Enzyme
(modulators)

ChATTooltip Choline acetyltransferase

AChETooltip Acetylcholinesterase

BChETooltip Butyrylcholinesterase

Inhibitors: Affinine
Affinisine
Conodurine
Cymserine
Ladostigil
Profenamine (ethopropazine)
Rivastigmine
Tacrine
ZINC-12613047
Many of the other AChE inhibitors listed above

Transporter
(modulators)

CHTTooltip Choline transporter

Inhibitors: Hemicholinium-3 (hemicholine)
Triethylcholine

Enhancers: Coluracetam

VAChTTooltip Vesicular acetylcholine transporter

Inhibitors: Vesamicol

Release
(modulators)

SNAP-25Tooltip Synaptosomal-associated protein 25 inactivators: Botulinum toxin (A, C, E)

VAMPTooltip Vesicle-associated membrane protein inactivators: Botulinum toxin (B, D, F, G)

Others: Bungarotoxins (β-bungarotoxin, γ-bungarotoxin)

LPHNTooltip Latrophilin agonists: α-Latrotoxin

Others: Atracotoxins (e.g., robustoxin, versutoxin)
Crotoxin

See also: Receptor/signaling modulators; Muscarinic acetylcholine receptor modulators; Nicotinic acetylcholine receptor modulators

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