Antidotes in Poisoning : Specific Antidotes
IPAMP1 “Pampara injection” 25 mg/ml, 20 ml/amp
適應症：巴拉松（parathion）、甲基巴拉松（methyl parathion）等有機磷劑、農藥中毒之解毒劑
Usual dose:
IV infusion rate should not to exceed 200 mg/min.
Anticholinesterase overdose (myasthenia gravis):1 to 2 g IV followed by 250 mg IV q5m .
Organophosphate poisoning: initial, 1-2 gm in 100 ml NS IV infused > 15-30 min or 5% solution in sterile water for injection over > 5 min; may repeat after 1 hour if muscle weakness persists.
Poisoning due to nerve gas; Adjunct: 600 mg IM (prefilled autoinjector); may repeat every 15 minutes up to 3 injections if symptoms persist.
Dose adjustment:
Organophosphate poisoning(≦16 yrs): initial, 20-50 mg/kg IV infusion > 15-30 min(not to exceed 2000 mg/dose); additional doses may be given every 10 to 12 hours if muscle weakness persists.
Renal impairment: dose should be reduced
Contraindication: hypersensitivity to pralidoxime
Precautions：
Myasthenia gravis (may precipitate myasthenic crisis).
Not effective in poisonings due to organophosphates without anticholinesterase activity.
Not effective in poisonings due to phosphorus/inorganic phosphates.
Slow IV infusion prevents tachycardia, laryngospasm, muscle rigidity.
Adverse effect:
Common: increased creatinine kinase level.
Serious: cardiac arrest, seizure, apnea, laryngeal spasm.