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Twapam (pralidoxime iodide) is an approved injectable cholinesterase reactivator developed and manufactured by Walker's Pharmaceuticals. It is used as an antidote to treat severe poisoning caused by organophosphate pesticides, chemicals, or nerve agents, as well as to manage anticholinesterase drug overdoses (such as those used in the treatment of myasthenia gravis). Pralidoxime iodide works by binding to and reactivating the acetylcholinesterase enzyme that has been inactivated by phosphorylation, thereby restoring normal neuromuscular transmission and relieving muscle paralysis, particularly in the respiratory muscles.
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