Pralidoxime Chloride (2-PAM Chloride)

Question 1

Class / Action

Answer 1

Cholinesterase Reactivator

1. Reactivates cholinesterase so destruction of accumulated acetylcholine can occur

Question 2

Onset / Duration

Answer 2

Onset of 15min / Duration of 3hours

Question 3

Indications

Answer 3

1. Organophosphate poisoning

2. Nerve Agent (GB or VX) Poisoning

Question 4

Contraindications

Answer 4

1. Hypersensitivity
2. Do Not Use with Morphine, Theophylline, Aminophylline, or Succinylcholine with this medication
3. Avoid Reserpine or Phenothiazine-Type Tranquilizer use with this medication.
4. This medication is Not Indicated as an antidoted for intoxication by pesticides of the carbamate class
5. This medication is Not Effective in the treatment of poisoning d/t phosphorus, inorganic phosphates, or organophosphates Not having anti-cholinesterase activity

Question 5

Precautions

Answer 5

1. Use Great Caution in treating organophosphate/nerve agent poisoning in cases of myasthenia gravis
2. Monitor the dosage in the presence of renal insufficiency

Question 6

Dosages / Administration

Answer 6

ADULT: 1 auto-injector (600mg) IM into thigh; May be repeated depending on symptoms

Question 7

Adverse Reactions

Answer 7

1. 40-60min after IM injection, mild to moderate pain may be experienced at the injection site
2. Blurred vision, Diplopia, Impaired accommodation, Dizziness, HA, Drowsiness, Nausea, Tachycardia, Increased BP, Hyperventilation, Muscular Weakness