Pralidoxime Chloride (2-PAM)



Pralidoxime Chloride (2-PAM)





(pra li dox’ eem)

Protopam Chloride

PREGNANCY CATEGORY C


Drug Class

Antidote


Therapeutic Actions

Reactivates cholinesterase (mainly outside the CNS) inactivated by phosphorylation due to organophosphate pesticide or related compound. Relieves respiratory muscle paralysis related to organophosphate toxicity.


Indications



  • Antidote in poisoning due to organophosphate pesticides and chemicals with anticholinesterase activity


  • IM use as an adjunct to atropine in poisoning by nerve agents having anticholinesterase activity (autoinjector)


  • Control of overdose by anticholinesterase drugs used to treat myasthenia gravis



Available Forms

Injection—1 g


Dosages

Adults



  • Organophosphate poisoning: In absence of cyanosis, give atropine 2–4 mg IV. If cyanosis is present, give 2–4 mg atropine IM while improving ventilation; repeat
    every 5–10 min until signs of atropine toxicity appear. Maintain atropinization for at least 48 hr. Give pralidoxime concomitantly: Inject an initial dose of 1–2 g pralidoxime IV, preferably as a 15- to 30-min infusion in 100 mL of saline. After 1 hr, give a second dose of 1–2 g IV if muscle weakness is not relieved. Give additional doses cautiously every 10–12 hr. If IV administration is not feasible or if pulmonary edema is present, give IM or subcutaneously.


  • Anticholinesterase (eg, neostigmine, pyridostigmine, ambenonium) overdose: 1–2 g IV followed by increments of 250 mg every 5 min.

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Jul 21, 2016 | Posted by in NURSING | Comments Off on Pralidoxime Chloride (2-PAM)

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