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Pralidoxime chloride
Aka: Pralidoxime chloride, Protopam chloride, 2-PAMCl
- Indications
- Nerve Agent Exposure
- Organophosphate Exposure
- Not indicated for pure carbamate Poisoning
- Pharmacokinetics
- Binds Nerve Agent and breaks agent-enzyme bond
- Less effective after Nerve Agent aging occurs
- Soman (GD) ages in 2 minutes
- Other Nerve Agents age over 24-48 hours
- Dosing: Emergency Department
- Initial IV bolus
- Adult: 1-2 grams IV over 10 minutes
- Child age < 12 years: 20-50 mg/kg IV over 30 minutes
- Maintenance Protocol 1 (bolus)
- Repeat dosing above in 1-2 hours
- May re-administer q10-12 hours prn symptoms
- Maintenance Protocol 2 (Continuous infusion)
- Continuous IV 10-20 mg/kg/hr up to 500 mg per hour
- Discontinue at 24 hours
- Dosing: Military (MARK I Kit)
- MARK I Kit Autoinjector contains 2-PAMCl 600 mg
- Atropine usually administered prior to 2-PAMCl
- Precautions
- Do NOT administer more than 3
- Cardiac Arrest risk