Drug Interaction:
Not reported
Indication:
Antidote for organophosphorus poisioning like malathion, TEPP, parathion, dichlorovos, fenthion
Adverse Reaction:
Combination of atropine and pralidoxime - when used together the signs of atropinization
occur earlier than might be expected when atropine is used alone
Lab test abnormalities - elevation of AST or ALT enzymes levels were observed
Local - 40 to 60 minutes after IM injection, mild to moderate pain may be experienced at site
of injection.
Miscellaneous reactions- blurred vision, diplopia, and impaired accomodation,
Dizziness, headache, drowsiness, nausea, tachycardia, increased systolic and
diasystolic pressure, hyperventilation, and muscular weakness when given
parenterally to patients exposed to anticholinesterase poisons.
Contra-Indications:
Hypersensitivity to the drug
Special precautions/ Warnings-
Phosphorus, inorganic phosphates, organophosphates- pralidoxime is not effective
in treatment of poisoning aused by phosphorus, inorganic phosphates, or
organophosphates not having anticholinesterase activity.
Carbamate pesticides- pralidoxime not indicated as an antidote for intoxification
by carbamate pesticides
General information- pralidoxime is well tolerated in most cases,
Injection rate- injection rate should not exceed 200mg/min . If IV administration is
not feasible use IM or subcutaneous injection.
Myasthenia gravis- use pralidoxime with great caution in treating organophosphate
overdoses in cases of myathenia gravis
Renal function impairment - reduce dosage in presence of renal insufficiency
Pregnancy- give to a pregnant women only if needed.
Lactation- excercise caution when administering to a breast feeding woman.
Children- safety and efficacy in pediatricpatients not established.
Dosages/ Overdosage Etc:
Indication-
Antidote for organophosphorus poisioning like malathion, TEPP, parathion, dichlorovos, fenthion
Dosage-
Give atropine as soon as possible after hypoxemia is improved. Do not give atropine in the
presence of significant hypoxia due to risk of atropine induced ventricular fibrillation.
In adults , atropine may be given IV in dose of 2-4mg. Repeat this at 5-10 minutes intervals until full atropine ( secretion are inhibited ) or signs of toxicity appear ( delirium , hyperthermia,
muscle twitching )
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
PRALIDOXINE- Systemic
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
pralidoxine. Also tell your healthcare care professional if you are allergic
to any other substances such as foods. preservatives or dyes.
2.Pregnancy-
Studies have not been done in humans or animals
.
3. Breast-feeding-
It is not known whether pralidoxine passes into breast milk. Mothers who are
taking this medicine and who wish to breast feed should discuss this
with their doctor.
4.Children-
Although there is no specific information comparing use of pralidoxine
in children with use in other age groups, this medicine is not expected
to cause different side effects or problems than it does in adults.
5.Older adults-
There is no specific information comparing use of pralidoxine in the elderly
with use in other age groups
6. Other medicines-
Tell your doctor if you are using any of the following -
Aminophylline or
Caffeine or
Theophylline - these medicines may make the effects of poisioning
worse
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Kidney disease- the effects of this medicine may be increased
Myasthenia gravis - this medicine may make the condition worse
Pregnancy and lactation:
Pregnancy-
Give to a pregnant women only if needd.
Lactation-
Excercise caution when administering to a breast feeding woman.
Children-
Safety and efficacy in pediatricpatients not established.