What Is Pralidoxime?

Jillian O Keeffe

Some drugs combat the effects of poison in the body, and pralidoxime is one of these drugs. Specific poisons that the medicine can treat include organophosphate pesticides and certain chemical warfare agents. Pralidoxime typically is used in conjunction with another drug called atropine.

Pralidoxime can be used in conjunction with rescue breathing and chest compressions to save the life of someone overdosing or who has been poisoned.
Pralidoxime can be used in conjunction with rescue breathing and chest compressions to save the life of someone overdosing or who has been poisoned.

When poisons such as military nerve agents or organophosphate fertilizers affect the human body, they have the effect of inactivating an enzyme called cholinesterase. The poisons act on the muscles of the body and paralyze their movement. Muscles are necessary for basic processes such as breathing, so this can be lethal. Pralidoxime makes the cholinesterase enzyme work again, thereby negating some of the adverse effects of the poison. It also can directly alter some of the poisons to harmless forms.

Pralidoxime side effects may include changes in blood pressure.
Pralidoxime side effects may include changes in blood pressure.

The result of these effects is that the paralyzed muscles caused by the poisoning can work again, and the poisoned person can breathe again. Atropine — another chemical that is administered with the drug — also has beneficial effects on breathing, but in a manner that is different from that of pralidoxime. Both drugs together give the best result on revival of breathing. Signs of poisoning that indicate the need for the drugs include unusually small pupils of the eye, loss of bowel control and convulsions.

Pralidoxime may be used in conjunction with atropine.
Pralidoxime may be used in conjunction with atropine.

Pralidoxime might be administered in case of accidental or deliberate ingestion of organophosphate pesticides. Examples of the pesticides that can be treated using the drug in case of poisoning include malathion, diazinon and sarin. An overdose of certain medical drugs might also be treatable with pralidoxime. People who have myasthenia gravis might take medications such as neostigmine, which can cause the same type of muscle paralysis as poisons if too much is ingested.

Members of the military might be trained in injection techniques and have access to the drug in case of terrorist attacks that involve nerve agents. This preparation can ensure that, in emergency situations, military personnel can treat themselves and avoid casualties. Pralidoxime might also be stockpiled in areas where nerve agents or organophosphates might be released in an industrial accident.

Potential side effects of this drug include soreness at the site of injection, vision issues and dizziness. Heart rhythms and blood pressure might be affected, as can muscle strength and alertness. If an overdose occurs, then medical support might be necessary to keep the patient breathing. As many as three injections of the drug, along with atropine, might be required to combat the effects of poisoning in certain situations.

Emergency services should be contacted if a pralidoxime overdose is suspected.
Emergency services should be contacted if a pralidoxime overdose is suspected.

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