Pralidoxime

Question 1

Brand names for Pralidoxime

Answer 1

2-pam, Protopam, Duodote (duodote has atropine in it too)

Question 2

Drug class of pralidoxime

Answer 2

Antidote, cholinesterase reactivator

Question 3

Pralidoxime’s mechanism of action

Answer 3

Reactivates cholinesterase to effectively act as an antidote to organophosphate and pesticide poisonings. This action allows for destruction of accumulated acetylcholine at the neuromuscular junction resulting in reversal of respiratory paralysis and paralysis of skeletal muscle.

Question 4

Indication for pralidoxime

Answer 4

As an antidote in the treatment of poisoning by organophosphate pesticides and chemicals. Anticholinesterase overdose (myasthenia gravis).

Question 5

Contraindications for pralidoxime

Answer 5

Reduce dose in patients with impaired renal functions, patients with myasthenia gravis, inorganic phosphates poisoning.

Question 6

Adverse effects of pralidoxime

Answer 6

Dizziness, drowsiness, headache, neuromuscular blockade, seizure, laryngospasm, hyperventilation, apnea, tachycardia, cardiac arrest, nausea, muscle rigidity, muscle weakness, rash, pain at the injection site.

Question 7

Precautions for pralidoxime

Answer 7

Do not use with other respiratory depressants,

Succinylcholine, or theophylline

Question 8

Adult dose and administration of pralidoxime

Answer 8

Adult: 600 mg IM auto-injector q 15 minutes may repeat twice more. IV infusion 1-2 g over 30-60 minutes. Dose can be repeated once in 1 hour.

Question 9

Pediatric dose and administration for Pralidoxime

Answer 9

Pedi Dose: 20-40 mg/kg as IV infusion over 15-30 minutes. Dose may be repeated in 1 hour. If IV administration is not feasible, IM injection may be used.