The continuous threat of organophosphorus (OP) nerve agent misuse supports the development of antidotes with enhanced potency. In this chapter, we are focusing on antidotal therapy with acetylcholinesterase (AChE) reactivators.
Although this group of compounds has been known for more than a half-century, there is no single compound that might counteract every nerve agent's lethal effects. This chapter describes in detail the design and synthesis of the AChE reactivators that have been developed within the last two decades.
Within the design of novel molecules, special emphasis is placed on the structural requirements (structure-activity relationship) of these compounds. Finally, several new trends in the development of new reactivators are discussed.