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Note that 2-PAM has an affinity for the acetylcholine anionic binding site on cholinesterase (right middle panel), which could explain the oxime related worsening of cholinergic side effects when 2-PAM is administered prior to the onset of action of atropine in the setting of organophosphate poisoning, by transiently preventing nerve-agent free cholinesterase from interacting with acetylcholine
Given the relatively high monthly cost of GLP-1s in the US, as well as the prevalence of obesity in that market, GLP-1s have attracted particular attention
Dose escalation follows a gradual schedule to minimise gastrointestinal side effects
That said, individual safety is a question for a licensed provider who knows the person's full history
Peura DA
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