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doi: 10.3390/ijms23147722 91

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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 primary metabolite of ifosfamide, aldoifosfamide, is also a substrate for aldehyde dehydrogenase, and this is consistent with low toxicity of the drug to the bone marrow and the GI tract due, as mentioned previously with cyclophosphamide, to the presence of high levels of the enzyme in these organs