Classes
DEA Class; Rx
Common Brand Names; Protopam, 2PAM Antidote, Pralidoxime Auto Injector
- Cholinergic, Toxicity Antidotes
Description
Parenteral cholinesterase reactivator; antidote to reverse muscle paralysis from organophosphate anticholinesterase poisoning or overdose of drugs used for myasthenia gravis; atropine must be administered concomitantly.
Indications
For use as an antidote to organophosphate insecticide toxicity.
For the treatment of cholinesterase inhibitor toxicity secondary to agents used in the treatment of myasthenia gravis (e.g., neostigmine, pyridostigmine).
Contraindications
None for the approved indications
Adverse Effects
Pain at site
Transient dizziness
Blurred vision
Double vision
Dizziness
Hypertension
Tachycardia
Cardiac arrest
Laryngospasm
Muscle rigidity
ALT (transient increase); AST (transient increase)
Respiratory/cardiac arrest if given too fast IV
Headache
Seizure
Drowsiness
Nausea
Warnings
Administer concomitant atropine
Not approved for the treatment of carabamate poisoning
Not indicated for poisoning resulting from inorganic phosphates, phosphorus, or organophosphates that do not involve anticholinesterase activity
Use caution in myasthenia gravis (may presipitate myasthenia crisis)
Not equally active against all organophosphates
Give IM if patient is cyanotic
Observe patients for at least 24 hr
Pregnancy and Lactation
Pregnancy Category: C
Maximum Dosage
2 g/dose IV/IM/SC.
2 g/dose IV/IM/SC.
Safe and effective use has not been established; doses up to 50 mg/kg/dose IV/IM/SC (not to exceed 2g/dose) have been recommended for the management of organophosphate insecticide toxicity.
Safe and effective use has not been established; doses up to 50 mg/kg/dose IV/IM/SC (not to exceed 2g/dose) have been recommended for the management of organophosphate insecticide toxicity.