Pralidot Injection
Pralidoxime Chloride
1 gm/vial
Globe Pharmaceuticals Ltd.
| Pack size | |
|---|---|
| Unite Price | 500.00 BDT |
Indications
Pralidot Injection is used for:
Organophosphorous poisoning, Overdoses of anticholinesterase drugs used in the treatment of, myasthenia gravis.
Adult Dose
Organophosphorous Poisoning
For IV Infusion:
Adults: 1-2 g IV as 15-30 min infusion, repeat a second dose of 1 g to 2 g may be indicated after about one hour if muscle weakness has not been relieved. Additional doses may be given every 10-12 hours if muscle weakness persists.
OR
Use with atropine, which affects muscarinic receptors; pralidoxime's actions most striking at nicotonic sites (increase muscle strength 10-40 min)
For IV Injection: For fluid restricted patient 1 g, should be slowly given (over not less than 5 minutes) by IV injection, as 50 mg/ml solution in normal saline (e.g. 1 g in 20 ml).
IM: 600 mg IM x3 doses; administer each dose 15 minutes apart for mild symptoms, or in rapid succession for severe symptoms
Acetylcholinesterase Inhibitor Toxicity
Initial: 30 mg/kg IV (IM, SC if no IV access) over 20 min
4-8 mg/kg/hr IV infusion
Child Dose
Organophosphorous Poisoning
For IV Infusion:
Children > 16 years of age: 1-2 g IV as 15-30 min infusion, repeat a second dose of 1 g to 2 g may be indicated after about one hour if muscle weakness has not been relieved. Additional doses may be given every 10-12 hours if muscle weakness persists.
OR
Use with atropine, which affects muscarinic receptors; pralidoxime's actions most striking at nicotonic sites (increase muscle strength 10-40 min)
For IV Injection: For fluid restricted patient 1 g, should be slowly given (over not less than 5 minutes) by IV injection, as 50 mg/ml solution in normal saline (e.g. 1 g in 20 ml).
Children < 16 years of age: Loading dose: 20-50 mg/kg (maximum: 2000 mg/dose); Maintenance infusion: 10-20 mg/kg/hour; alternatively, a repeat bolus of 20-50 mg/kg (maximum 2000 mg/dose) may be administered after 1 hour and repeated every 10-12 hours thereafter, as needed.
IM administration
<40 kg: 15 mg/kg/dose IM x3 doses
40 kg or greater: Administer as in adults; 600 mg/dose IM x3 doses
Renal Dose
Renal Impairment: Reduce dose
Administration
IV Preparation
Reconstitute by adding 20 mL SWI to the 1 g vial to provide a 50 mg/mL solution (do not use preservative-containing solutions)
IV Administration
For infusion, dilute required amount of reconstituted solution to 100 mL with NS
Infuse over 15-30 min
May also be given as 5 min slow IVP
IM Administration
1 g vial contents may be reconstituted by adding 3 mL SWI or NS to provide a 300 mg/mL solution
Contra Indications
Carbamate pesticide poisoning, hypersensitivity.
Precautions
The following precautions should be kept in mind in the treatment of acetylcholinesterase poisoning, although they do not bear directly on the use of Pralidoxime Chloride, since barbiturates are potentiated by the anticholinesterases, they should be used cautiously in the treatment of convulsion; morphine, theophylline, aminophylline, succinylcholine, reserpine and phenothiazine-type tranquilizers should be avoided in patients with organophosphate poisoning. Prolonged paralysis has been reported with patients when succinylcholine is given with drugs having anticholinesterase activity; therefore it should be used with cautions. Pregnancy, lactation.
Pregnancy-Lactation
Pregnancy Category: C
Interactions
Side Effects
Side effects of Pralidoxime Chloride :
Drowsiness, dizziness, visual disturbances, nausea, tachycardia, headache, hyperventilation and muscle weakness.
Potentially Fatal: Rapid admin causes tachycardia, laryngospasm and rigidity. Large doses cause neuromuscular blockade.
Mode of Action
Pralidoxime reactivates cholinesterase outside the CNS which has been inactivated by phosphorylation due to organophosphate pesticide exposure-resulting. This leads to the destruction of acetylcholine at the neuromuscular junction thus relieving muscle paralysis. It also removes the phosphyl group from the active site of inactivated enzyme which is dependent on the nature of the phosphyl group.
Note
Pralidot 1 gm/vial Injection generic name is Pralidoxime Chloride. Pralidot 1 gm/vial Injection is manufactured by Globe Pharmaceuticals Ltd.Pralidot is availble in all over Bangladesh.
Mes BD drug index information on Pralidot Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.