CONTRATHION INJ (PRALIDOXIM)

Pralidoxime injection is a cholinesterase reactivator that primarily works by reversing the effects of organophosphate poisoning. Its mechanism of action involves binding to and reactivating the enzyme acetylcholinesterase (AChE) at the neuromuscular junction. Organophosphates inhibit AChE, leading to the accumulation of acetylcholine and subsequent overstimulation of cholinergic receptors. Pralidoxime displaces the organophosphate from the enzyme, restoring its normal function. This action helps to counteract the toxic effects of organophosphate exposure, such as muscle paralysis, respiratory distress, and other symptoms associated with cholinergic crisis. By reactivating AChE, pralidoxime promotes the breakdown of acetylcholine, thereby restoring normal neuromuscular transmission and mitigating the life-threatening effects of organophosphate poisoning.

Antidote, cholinesterase reactivator

Injection

The following are the uses of PRALIDOXIM Injection:

• Used for treating organophosphate poisoning, a life-threatening condition caused by certain pesticides and nerve agents.
• Used for reversing the effects of organophosphate-based insecticides and chemicals on the nervous system.
• Used for stabilizing patients experiencing severe muscle weakness, respiratory issues, and confusion due to organophosphate exposure.
• Used for counteracting the inhibition of acetylcholinesterase, an essential enzyme for nerve function, by organophosphate compounds.
• Used for improving symptoms like blurred vision, drooling, and excessive sweating associated with organophosphate poisoning.
• Used for enhancing the recovery process and reducing long-term neurological damage in organophosphate poisoning cases.
• Used for supporting respiratory function and preventing respiratory failure in severe poisoning cases.

In the case of an overdose of PRALIDOXIM Injection, it is crucial to seek immediate medical assistance. Symptoms of an overdose may include excessive sweating, nausea, vomiting, and muscle weakness. Medical professionals should closely monitor vital signs and provide supportive care. Prompt treatment can help manage the adverse effects and ensure the patient's well-being. It is important to administer the correct dosage to prevent such incidents.

In the case of a missed dose of PRALIDOXIM Injection, it is important to administer the medication as soon as possible. If it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one. However, if you have missed multiple doses or are unsure about the timing, contact your healthcare professional for guidance on how to proceed. They will provide specific instructions based on your medical condition and treatment plan.

To administer PRALIDOXIM Injection, gently shake the vial to ensure the solution is well-mixed, draw the prescribed dose into a syringe, and inject it intramuscularly or intravenously as directed by your healthcare professional, following the recommended dosage and administration guidelines provided.

Here are the conditions or situations when PRALIDOXIM Injection should not be used:

• Should not be administered to individuals with a known allergy or hypersensitivity to pralidoxime or any of its components.
• Contraindicated in patients with known deficiency of the enzyme acetylcholinesterase.
• Not recommended for individuals with certain neuromuscular disorders, such as myasthenia gravis or Eaton-Lambert syndrome.
• Should not be used in patients with untreated cholinergic crisis or excessive cholinergic stimulation.
• Contraindicated in patients with a history of severe kidney disease or those currently on dialysis.

The side effects of PRALIDOXIM Injection may include:

• Nausea and vomiting
• Excessive salivation
• Increased sweating
• Blurred vision or eye pain
• Abdominal cramps and diarrhea
• Slow or irregular heartbeat
• Allergic reactions, such as skin rash, itching, or difficulty breathing.

Following are the precautions and warnings for PRALIDOXIM Injection:

• This medication is intended for intramuscular or intravenous use only and should be administered by trained medical professionals. Do not inject subcutaneously or intradermally.
• PRALIDOXIM should be used with caution in patients with known allergies or sensitivities to any of its components, and alternative treatments should be considered in such cases.
• It is crucial to monitor patients for signs of anaphylaxis or severe allergic reactions during and after administration, especially in individuals with a history of allergies.
• PRALIDOXIM may cause life-threatening adverse reactions, including cardiovascular and respiratory complications. Immediate medical attention should be sought if these occur.
• Patients with underlying medical conditions, particularly cardiovascular or respiratory issues, should be closely monitored as PRIDOXIM may exacerbate these conditions.
• This medication can cause dizziness and blurred vision, so patients should avoid driving or operating heavy machinery until they know how the medication affects them.
• PRALIDOXIM should be used with caution in elderly patients as they may be more susceptible to its side effects.
• It is essential to ensure that the correct dose is administered, as overdosing can lead to severe health risks.

Following are the drug interactions for PRALIDOXIM Injection:

• Concurrent use with cholinesterase inhibitors like neostigmine or pyridostigmine may result in additive pharmacological effects and increased adverse reactions.
• Co-administration with succinylcholine, a muscle relaxant, can prolong the duration of action of succinylcholine.
• The effectiveness of PRALIDOXIM may be reduced when used with anticonvulsant medications like phenytoin or carbamazepine.
• Drugs that induce liver enzymes, such as rifampin, may decrease the therapeutic effect of PRALIDOXIM by increasing its metabolism.
• Caution is advised when using PRALIDOXIM with neuromuscular blocking agents, as it may prolong neuromuscular blockade.
• The interaction with neuromuscular non-depolarizing agents like vecuronium can lead to prolonged respiratory muscle paralysis.
• Concurrent use with aminoglycoside antibiotics may increase the risk of neuromuscular blockade and respiratory depression.

Following are the food interactions for PRALIDOXIM Injection:

• Alcohol consumption should be avoided as it may impair your ability to drive or operate machinery, especially when combined with the medication's potential side effects.
• Grapefruit and grapefruit juice should be consumed with caution as they can inhibit certain enzymes, potentially altering the metabolism of PRALIDOXIM and leading to increased side effects.
• Avoid high-fat meals as they may delay the absorption of PRALIDOXIM, affecting its effectiveness.
• Caffeine intake should be monitored as it can potentially interact with the medication, leading to increased nervousness and irritability.
• Avoid consuming large amounts of vitamin C-rich foods, as high doses of vitamin C may reduce the effectiveness of PRALIDOXIM.
• Certain herbal supplements, such as St. John's Wort, may interact with PRALIDOXIM, so consult your healthcare provider before taking any herbal remedies.
• Always inform your healthcare provider about your dietary habits and any supplements you are taking to ensure safe and effective use of PRALIDOXIM Injection.
• Stay well-hydrated and maintain a balanced diet to support overall health during the treatment.

Pralidoxim Injection should be stored in a controlled environment, preferably in a secure and designated storage area. Maintain a cool and dry condition, ideally at room temperature between 20-25°C (68-77°F). Protect the injection from direct sunlight, heat, and moisture to ensure its stability and effectiveness. Store it in its original packaging, ensuring the container is tightly sealed to prevent contamination. Regularly check the expiration date, and dispose of any expired or unused injections according to local pharmaceutical waste management guidelines. Do not dispose of it in regular household waste, and keep it away from children and pets to prevent accidental exposure.

Following are the quick tips for PRALIDOXIM Injection:

• Administer the injection under medical supervision for safety and proper administration.
• Ensure the injection is stored at the appropriate temperature, as directed by the manufacturer.
• Verify the patient's identity and medical records before injecting to ensure the right patient and medication.
• Use sterile techniques when preparing and administering the injection to prevent infection.
• Inject the medication slowly as prescribed, and follow the recommended infusion rate.
• Monitor the patient for any adverse reactions during and after the injection.
• Dispose of used needles and syringes safely in designated sharps containers.