Oximes for treatment of peripheral and central nervous system exposure to acetyl cholinesterase inhibitors

A pharmaceutical composition comprising:

• (a) an acetyl cholinesterase reactivator compound of a formula:
• or a pharmaceutically acceptable salt thereof, in an amount ranging from 1.0 mg to 2,000 mg,
• wherein V is independently a hydrogen, an alkyl (C1 to C5) group, or a benzyl or substituted benzyl group;
• Z is independently an optionally substituted methylene or methine group from 1 to 8 carbon atoms in length, and wherein in the case of optionally substituted methylene or methine, Z can also be connected to R1 to form a heterocyclic or bicyclic heteratom ring from 3 to 10 atoms;
• R1 can independently be H or optionally substituted alkyl (C1 to C7), or can be connected to Z to form a heterocyclic or bicyclic heteratom ring from 3 to 10 atoms;
• R2 is independently H or optionally substituted alkyl (C1 to C7), benzyl or optionally substituted benzyl, phenyl, optionally substituted phenyl, heterocyclic, heteroaryl and optionally substituted heterocyclic or optionally substituted heteroaryl;
• and
• X is independently H, cyano (CN) or COR, wherein said R group is alkyl (C1 to C3);
• and
• (b) a pharmaceutically acceptable buffered aqueous carrier solution,
• wherein the pH of the pharmaceutical composition is greater than 8 and wherein the pharmaceutical composition is sterile.