<--back to pharmacology table of contents
 

 

Pralidoxime Chloride (Protopam® Chloride, 2-PAM, 2-PAM Chloride)

Class: Cholinesterase reactivator
Route: Deep IM

Adult Dose:

600mg (1 autoinjector) - 1800mg (3 autoinjectors) - standing order
Pediatric Dose: Not generally administered to pediatric patients
Drug Action:
  • Reactivates cholinesterase which has been deactivated by chemical nerve agents and organophospate poisons
  • Relieves paralysis of the respiratory muscles following chemical nerve agent or organophospate exposure
Onset: About 15 minutes
Duration: About 1 hour
Indications:
  • Second drug given for the treatment of poisoning due to organophosphate pesticides and chemical nerve agents (First drug is atropine)
  • Primary indication for pralidoxime administration is muscle weakness or respiratory depression in these patients
Precautions:
  • Not indicated for poisonings with carbamate pesticides
  • Effects during pregnancy are unknown
  • Safety and efficacy in children is unknown
  • Do not administer more than 3 autoinjectors due to its hypertensive effects
Side Effects:
  • Tachycardia, laryngospasm, muscle rigidity if IV and infused too quickly
  • Mild to moderate pain at injection site
  • Blurred or double vision, dizziness, loss of coordination, headache drowsiness, hypertension, tachycardia

 

 

<--back to pharmacology table of contents