You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is In which of the following poisoning, pralidoxime is ineffective? and explain in detail?
Oximes are used to displace organophosphates from the active site of acetylcholinesterase, thus reactivating the enzyme. Pralidoxime is a specific antidote that restores acetylcholinesterase activity by regenerating phosphorylated acetylcholinesterase and appears to prevent toxicity by detoxifying the remaining organophosphate molecules. Clinically, pralidoxime ameliorates muscarinic, nicotinic, and central neurologic symptoms. Pralidoxime is not recommended for asymptomatic patients or for patients with known carbamate exposures presenting with minimal symptoms. There is increased toxicity of pralidoxime in carbaryl poisoning. Ref: Robey III W.C., Meggs W.J. (2011). Chapter 195. Pesticides. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.