pralidoxime (2-PAM, Protopam, Pralidoximum, Contrathion)

Introduction

Tradename: 2-PAM. (pralidoxime chloride)

Indications

• organophosphate poisoning
  • antidote in poisoning due to organophosphate pesticides & other chemicals with anticholinesterase toxicity

generally used in combination with atropine

Dosage

• 1-2 g IV/IM/SC
• may be repeated in 30 min if needed

Pharmacokinetics

• rapid onset of action when given IV/IM
• distributes to extracellular water
• does not readily pass into CNS
• metabolized by the liver
• eliminated in the urine
• 1/2life is 60-80 minutes

elimination via kidney

1/2life = 60-80 minutes

Adverse effects

• elevated serum transaminases
• elevated creatine kinase
• dizziness
• double vision
• blurred vision
• muscular weakness
• elevated blood pressure
• tachycardia

Drug interactions

• pralidoxine potentiates effects of barbiturates

Mechanism of action

• reactivates cholinesterase (mainly outside the CNS)

More general terms

• antidote

Component of

• atropine/pralidoxime (Duodote)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=4884
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5797
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=65342
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=65349
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=65350
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=407614
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=199089
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=89469