Atropine Pralidoxime

What is Atropine Pralidoxime

Atropine pralidoxime are used together in an intramuscular parenteral preparation to treat organophosphate nerve poisoning.

Pralidoxime is an agent that reactivates cholinesterase.

Atropine is an antimuscarinic agent that decreases the muscarinic cholinergic adverse reactions associated with the organophosphate toxicity (e.g., lacrimation, sweating, breathing problems, slow heart rate).

ATNAA (Antidote treatment-Nerve Agent Auto-injector) is FDA-approved for US military use.

DuoDote is FDA-approved for use in civilians; it is only distributed to emergency medical service organizations or their suppliers.

Indications

  • organophosphate insecticide toxicity

For the treatment of life-threatening exposure to susceptible organophosphate nerve agents or organophosphate insecticides (i.e., organophosphate insecticide toxicity) having anticholinesterase activity

Side Effects

  1. local injection site reaction
  2. muscle tightness and mild to moderate pain
  3. dryness of the mouth
  4. blurred vision, dry eyes
  5. photophobia
  6. confusion
  7. headache
  8. dizziness
  9. tachycardia
  10. palpitations
  11. flushing
  12. urinary hesitancy or retention
  13. constipation
  14. abdominal pain
  15. abdominal distention
  16. nausea and vomiting
  17. loss of libido
  18. impotence
  19. heat intolerance
  20. impairment of temperature regulation
  21. Dysphagia
  22. paralytic ileus
  23. acute angle closure glaucoma
  24. maculopapular rash
  25. petechial rash
  26. scarlatiniform rash

Serious Side effects

  1. sinus tachycardia
  2. palpitations
  3. premature ventricular contractions
  4. atrial flutter
  5. atrial fibrillation
  6. ventricular flutter
  7. ventricular fibrillation
  8. cardiac syncope
  9. asystole
  10. myocardial infarction
  11. restlessness
  12. tremor
  13. fatigue
  14. locomotor difficulties
  15. delirium
  16. hallucinations

Contraindications

  • bladder obstruction
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • chronic lung disease (CLD)
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • coronary artery disease
  • emphysema
  • glaucoma
  • hyperthermia
  • myocardial infarction
  • pregnancy
  • pyloric stenosis
  • requires an experienced clinician
  • strenuous exercise
  • urinary retention
  • urinary tract obstruction

Interactions

No information is available regarding drug interactions associated with Atropine Pralidoxime

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