Drug Detail:Atnaa (Atropine and pralidoxime [ at-roe-peen-and-pral-i-dox-eem ])
Generic Name: atropine and pralidoxime chloride
Dosage Form: injection
Drug Class: Antidotes
For optimal reactivation of organophosphorous-inhibited cholinesterase, the ATNAA should be administered as soon as possible after appearance of symptoms of nerve agent poisoning (see below).
The ATNAA should be self- or buddy-administered by military personnel after donning protective mask and hood at the first sign of a chemical attack, and only if some or all of the following mild symptoms of nerve agent exposure are present:
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- Unexplained runny nose
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- Unexplained sudden headache
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- Sudden drooling
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- Difficulty in seeing (dimness of vision and miosis)
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- Tightness of chest or difficulty in breathing
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- Wheezing and coughing
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- Localized sweating and muscular twitching in the area of contaminated skin
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- Stomach cramps
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- Nausea, with or without vomiting
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- Tachycardia followed by bradycardia
The following are the instructions that should be given to military personnel.
Self-Aid
- Administer one (1) ATNAA into your lateral thigh muscle or buttocks as follows:
- Remove gray safety cap from back end.
- Place front end on outer thigh and push hard until injector functions.
Hold firmly in place for ten seconds. - Using a hard surface, bend needle into hook. Push ejected needle through a pocket flap (or other thick and conspicuous part of outer clothing).
- Wait 10 to 15 minutes for the antidote to take effect. If you are able to ambulate, know who you are, and where you are, you will NOT need a second injection. Warning: Giving yourself a second set of injections may cause an overdose of the ATNAA which could result in incapacitation.
- If symptoms of nerve agent poisoning are not relieved after administering one injection, seek someone else to check your symptoms. A buddy must administer the second and third injections, if needed.
Buddy-Aid
- Casualties with severe symptoms may experience most or all of the mild symptoms described above, plus most or all of the following:
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- Strange or confused behavior
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- Increased wheezing and increased difficulty in breathing
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- Severely pinpointed pupils
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- Red eyes with tearing
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- Vomiting
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- Severe muscular twitching and general weakness
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- Involuntary urination and defecation
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- Convulsions
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- Unconsciousness
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- Respiratory failure
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- Bradycardia
- If you encounter a service member suffering from severe signs of nerve agent poisoning, render the following aid:
- Mask the casualty, if necessary. Do not fasten the hood.
- If self-aid (one ATNAA) has been administered, administer, in rapid succession, two (2) additional ATNAAs into the casualty's lateral thigh muscle or buttocks.
Note: Use the casualty's own ATNAAs when providing aid. Do not use your own injectors on a casualty. If you do, you may not have any antidote available when needed for self-aid.
- If self-aid (one ATNAA) has not been administered, administer, in rapid succession, three (3) ATNAAs into the casualty's lateral thigh muscle or buttocks.
IMPORTANT: PHYSICIANS AND/OR MEDICAL PERSONNEL ASSISTING EVACUATED VICTIMS OF NERVE AGENTS, SHOULD AVOID EXPOSING THEMSELVES TO CONTAMINATION BY THE VICTIM'S CLOTHING.