Pralidoxime

General
  • Type: Antidote
  • Dosage Forms:
  • Common Trade Names: Protopam

Adult Dosing

Organophosphate toxicity
  • 1-2gm IV over 5-10min
  • Continuous infusion of 500mg/hr if no initial response

Pediatric Dosing

Organophosphate toxicity
  • 20-40mg/kg (up to 1gm) IV over 5-10min
  • 5-10mg/kg/hr if no initial response

Special Populations
  • Pregnancy Rating: C
  • Lactation risk: Unknown
  • Renal Dosing
    • Adult - no requirements from manufacturer, but given that it is excreted in the urine dosage reduction is recommended.
    • Pediatric
  • Hepatic Dosing
    • Adult - no adjustments recommended by manufacturer.
    • Pediatric

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious

Pharmacology
  • Half-life: Apparent: 74 to 77 minutes, IM/IV exposure: 3 to 4 hours
  • Metabolism: Hepatic
  • Excretion: Urine
  • Mechanism of Action: Displaces an organophosphate from acetylcholinesterase (if given early before irreversible enzyme binding occurs, aka "aging")

See Also

Organophosphate Toxicity

References
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