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Operational Medicine 2001
Pralidoxime (Protopam)

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Category:

  • Nervous system

Description:

  • Anticholinesterase antidote

Indications:

  • Antidote in poisonings due to organophosphate pesticides and related compounds

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

Precautions:

  • Pregnancy category C

  • Rapid IV injection, impaired renal function

  • Myasthenia gravis, carbamate poisoning (less effective than with organophosphate poisoning)

Adverse Reactions (Side Effects):

  • CNS: dizziness, drowsiness, headache

  • CV: tachycardia

  • EENT: blurred vision, diplopia, impaired accommodation

  • GI: transaminase elevations, nausea

  • MS: muscular weakness

  • RESP: hyperventilation

  • SKIN: pain at injection site (IM)

Dosage:

Administered intramuscularly, intravenously

  • Adult:            

    • Organophosphate poisoning: 

      • IM/IV 1-2g, repeat in 1-2 hours if muscle weakness has not resolved, then at 10-12 hour intervals in cholinergic signs reappear

    • Anticholinesterase overdose: 

      • IV 1-2g followed by 250mg every 5 minutes until desired response

  • Child:            

    • Organophosphate poisoning: 

      • IM/IV 20-50 mg/kg/dose, repeat in 1-2 hours if muscle weakness has not resolved, then at 10-12 hour intervals if cholinergic signs reappear

 

 

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

 United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

*This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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