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.

Brands
CONTRATHION P-DOXIME
Adult Dose
Dose: 0.01 to 0.07 mg/kg
Single Dose: 0.04 (0.04)
Frequency: 0.5 hourly
Route: IM
Instructions: -
Neonatal
Dose: 20 to 60 mg/kg
Single Dose: 40 (40)
Frequency: As recommended.
Route: Slow IV
Instructions: Single Dose, can be repeated As Required
Paedriatic
Dose: 20 to 60 mg/kg
Single Dose: 40 (40)
Frequency: As recommended.
Route: Slow IV
Instructions: Single Dose, can be repeated As Required
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.The Molecular Weight of Pralidoxime is 172.60. It is weakly acidic drug, 2.87% solution of the drug is isotonic and Its pKa is 8.0.
Contraindications
Pralidoxime is contraindicated in conditions like Myasthenia gravis.
Effects
The severe or irreversible adverse effects of Pralidoxime, which give rise to further complications include Mania, Excitement.The symptomatic adverse reactions produced by Pralidoxime are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Tachycardia, Blurred vision, Diplopia, Muscular weakness, Disturbances of accomodation, Hyperventilation, Heaviness of eye.
Indications
Pralidoxime is primarily indicated in conditions like Poisoning of organophosphate.
Interactions
No data regarding the interactions of Pralidoxime was found.
Interfrence
Elevations of SGPT and SGOT
Risks
Drug should not be given to Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
IV Inj, IV Inf, IM Inj , SC Inj Store Below 25°C. Protect from Sunlight.
Warnings
Caution in required in administering pralidoxime to patients with myasthenia gravis, as it may precipitate a myasthenia crisis. Pralidoxime should be used cautiously in patients with impaired renal function, reduction in dose may be necessary. It should not be used to treat poisoning by carbamate pesticides. Avoid concurrent use with atropine.
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