Pralidoxime (2-pam)

  1. Class
    Cholinesterase reactivator
  2. Description
    Cholinesterase reactivator that can reverse respiratory depression and skeletal muscle paralysis resulting from organophosphate poisioning.
  3. Mechanism of Action
    Antidote for servere organophosphate poisonings. It chemically removes the phosphate group from cholinesterase that transferred from an organophosphate poison. Once cholinesterase is reactivated, it can deactivate acetycholine. Pralisoxime also detoxifies some organophosphates by direct chemical reaction.
  4. Onset of Action
    • Onset: Varies
    • Peak: 5-15 min (IV) 10-20 (IM)
    • Durtaion: Varies
    • Half Life: 0.8-2.7 hours
  5. Indications
    Severe organophosphate poisoning, Nerve Agents
  6. Contraindications
    Should not be used in cases of poisoning resulting from inorganic phosphates or the carbamate class of insecticides
  7. Precautions
    Always ensure safety and protection of rescue personnel, Laryngospasm, tachycardia, and muscle rigidity have occurred following rapid administered, should only follow atropinization
  8. Side effects
    AMS, blurred vision, dizziness, excitement, headache, increased salivation, manic behavior, nausea, tachycardia, vomiting
  9. Adult dose
    1-2g 250-500 ml of normal saline infused over 3 min
  10. Pedi dose
    20-40mg/kg by the same method
  11. Max dose
    1 time dose
  12. Routes of Administration
    IV/IO drip, IM
  13. Supplied
    Vials (?)
Card Set
Pralidoxime (2-pam)
Paramedic drugs