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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

The Arg-280 residue stably interacts with guanine bases in the major groove region of the target DNA, whereas the interactions involving Lys-120, Cys-277, and Ala-276 are sequence specific

PloS One 7, e30543 (2012)

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How Are Key Players Competing in the GLP-1 Receptor Agonist Market