Pralidoxime
Pralidoxime is a cholinesterase reactivator. Chemically Pralidoxime is 2-formyl-1-methylpyridinium. Pralidoxime is used as an antidote to reverse muscle paralysis resulting from organophosphate anticholinesterase pesticide poisoning. Because it does not significantly relieve depression of the respiratory center or decrease the muscarinic effects of anticholinesterase poisoning, atropine must be administered concomitantly to block the effects of the poison on these areas. Pralidoxime is also used to reverse the effects of overdosage of anticholinesterase agents used in the treatment of myasthenia gravis, i.e., neostigmine, pyridostigmine and ambenomium.
Primary Characteristics
It is of Synthetic origin and belongs to Pyridine.
It belongs to Cholinesterase reactivator pharmacological group on the basis of mechanism of action and also classified in Antidotes pharmacological group.
Molecular Weight: 172.6 · pKa: 8.0 · Solubility in Water: 1 in 20 · Solubility in Alcohol: 1 in 100 · Non-proprietary name: Pralidoxime · pH: 4.6 · Isotonic value: 2.87.
Pharmacokinetics
Absorption: Pralidoxime has an oral bioavailability is 22.5% (±7.5%).
Distribution: Pralidoxime has a volume of distribution is 0.6 l/kg. plasma protein binding is negligible.
Elimination: it is metabolised via Hepatic, plasma half-life is 75 min, renal excretion is extensive.
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Indications
Pralidoxime is primarily indicated in conditions like Poisoning of organophosphate.
Contraindications
Pralidoxime is contraindicated in conditions like Myasthenia gravis.
Dosage
Pralidoxime's dosage details are as follows:
| Dose | Single Dose | Frequency | Route | Instructions |
|---|---|---|---|---|
| Adult Dosage | ||||
| 0.04 mg/kg | 0.04 mg/kg | Every 0.5h | IM | - |
| 0.04 mg/kg | 0.04 mg/kg | Every 0.5h | IV | - |
| 2.14 mg/kg.min | 2.14 mg/kg.min | — | IV Inf | For 15-30 Minutes |
| Paediatric Dosage (20kg) | ||||
| 40 mg/kg | 40 mg/kg | — | Slow IV | Single Dose, can be repeated As Required |
| Neonatal Dosage (3kg) | ||||
| 40 mg/kg | 40 mg/kg | — | Slow IV | Single Dose, can be repeated As Required |
Drug Interactions
Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Side Effects
Pralidoxime in overdosage may give rise to further complications which include Excitement , Mania .
Pralidoxime is known to cause more or less tolerable side effects which are usually transient. These include Blurred vision, Diplopia, Disturbances of accomodation, Dizziness, Headache, Heaviness of eye, Hyperventilation , Muscular weakness, Nausea, Tachycardia.
Warnings / Precautions
Interference in Pathology
Pralidoxime may interfere in the diagnosis of Elevations of SGPT and SGOT .
Available Brands
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Single Ingredient
Storage Conditions
Drug Classification
- 1.4.2.3 — Organophosphate and carbamate poisoning