Neopam Injection
Pralidoxime Chloride
500mg
Troikaa Pharmaceuticals Ltd.
| Pack size | 2ml |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 29.00 NPR |
Indications
Neopam Injection is used for:
Organophosphorous poisoning
Adult Dose
Organophosphate Poisoning
1-2 g IV as 15-30 min infusion, repeat in 1 hr if necessary, OR
Use with atropine, which affects muscarinic receptors; pralidoxime's actions most striking at nicotonic sites (increase muscle strength 10-40 min)
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
Organophosphate Poisoning
IV loading dose followed by continuous infusion
20-50 mg/kg/dose (not to exceed 2 g/dose) infused IV over 15-30 minutes
Maintenance: 10-20 mg/kg/hr IV continuous infusion
IV intermittent infusions
20-50 mg/kg (not to exceed 2 g/dose) IV infused over 15-30 minutes
A second dose of 20-50 mg/kg may be indicated after about 1 hr if muscle weakness has not been relieved
May repeat q10-12hr prn
Other IV administration
If it is not practical to administer intermittent or continuous IV infusions, or if pulmonary edema is present, the 20-50 mg/kg dose should be given slowly (infused over at least 5 minutes) by IV injection as a 50 mg/mL solution in water
Additional doses may be given every 10-12 hours if muscle weakness persists
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
Administer each dose 15 minutes apart for mild symptoms, or in rapid succession for severe symptoms
Administer in the anterolateral aspect of the thigh to avoid the nerve, artery and vein, as well as the femur
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
Renal dysfunction, myasthenia gravis. Atropinisation may occur faster when atropine and pralidoxime are used together. Pregnancy, lactation.
Pregnancy-Lactation
Interactions
Adverse 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.
Mechanism 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
Neopam 500mg Injection manufactured by Troikaa Pharmaceuticals Ltd.. Its generic name is Pralidoxime Chloride. Neopam is availble in Nepal.
Farmaco Nepal drug index information on Neopam Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.