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

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

Contraindications: No absolute contraindications

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 auto-injectors, 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

Adult Dose: 600mg (1 autoinjector) - 1800mg (3 auto-injectors) - standing order

Pediatric Dose: Not generally administered to pediatric patients – Contact BioTel

Route: Deep IM

Drug Action:

• Reactivates cholinesterase which has been deactivated by chemical nerve agents and organophosphate poisons
• Relieves paralysis of the respiratory muscles following chemical nerve agent or organophosphate exposure

Class: Cholinesterase reactivator

Onset: About 15 minutes

Duration: About 1 hour