CHARLES W. WILSON, M.D.; JOHN P. WILLIAMS, M.D., F.A.C.P.; DAVID H. MILLER, M.S.(Biochem.)
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Octamethyl pyrophosphoramide (OMPA), a potent anticholinesterase, was first synthesized and shown to exhibit insecticidal activity by Schrader1 in Germany in 1948. Studies by DuBois, Doull and Coon2 revealed that this compound was converted by the liver into an agent which inhibited peripheral cholinesterase activity but had no effect on the brain cholinesterase, thus causing no symptoms referable to stimulation of the central nervous system. This selective peripheral action renders octamethyl pyrophosphoramide (OMPA) more desirable for the treatment of myasthenia gravis than those alkyl phosphates which inhibit both central and peripheral cholinesterase. Since atropine will not antagonize the central effects of
WILSON CW, WILLIAMS JP, MILLER DH. THE HAZARD OF CHOLINERGIC CRISIS DURING TREATMENT OF MYASTHENIA GRAVIS WITH OCTAMETHYL PYROPHOSPHORAMIDE*. Ann Intern Med. 1952;37:574–579. doi: https://doi.org/10.7326/0003-4819-37-3-574
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Published: Ann Intern Med. 1952;37(3):574-579.
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