Usual Adult Dose for Organophosphate Poisoning

DuoDote(R) autoinjector:

Mild symptoms in patients over 41 kg, patient has 2 or more mild symptoms of poisoning:
First dose: 1 injection intramuscularly into the mid-lateral thigh

• If patient develops severe symptoms after first dose, give 2 additional injections intramuscularly in rapid succession
• Wait 10 to 15 minutes after first injection, if no severe symptoms develop, no additional injections are recommended.

Severe symptoms in patients over 41 kg:
Give 3 injections intramuscularly in rapid succession in the mid-lateral thigh

ATNAA(R):

• Self or buddy-administer by military personnel after donning protective mask and hood at the first sign of a chemical attack, and only if some or all mild symptoms are present.

Self aid: Administer 1 injection into the lateral thigh muscle or buttocks

• Wait 10 to 15 minutes for antidote to take effect; if you can ambulate and know who and where you are, you do not need a second injection
• If symptoms are not relieved by one injection, seek someone else to check your symptoms; a buddy must administer second and third injections if needed.

Buddy aid: For patients with severe symptoms:

• If one injection (self aid) has been administered, administer 2 more injections in rapid succession into the lateral thigh or buttocks.
• If no medication has been given, administer 3 injections in rapid succession into the lateral thigh or buttocks.

Mild symptoms:

• Blurred vision/miosis
• Excessive, unexplained teary eyes
• Excessive, unexplained runny nose
• Increased salivation such as sudden drooling
• Chest tightness or difficulty breathing
• Tremors throughout the body or muscular twitching
• Nausea and/or vomiting
• Unexplained wheezing, coughing, or increased airway secretions
• Acute onset stomach cramps
• Tachycardia or bradycardia
• Unexplained, sudden headache
• Localized sweating and muscular twitching in the area of contaminated skin

Severe symptoms:

• Strange or confused behavior
• Severe difficulty breathing or copious secretions form lungs/airway
• Severe muscular twitching and general weakness
• Involuntary urination and defection
• Convulsions
• Unconsciousness

Comments:

• Only administer for symptoms where organophosphorous poisoning is known or suspected.
• Administer as soon as possible after appearance of symptoms.

Use(s): Poisoning by organophosphorous nerve agents and organophosphorous insecticides.

Usual Adult Dose for Nerve Agent Poisoning

DuoDote(R) autoinjector:

Mild symptoms in patients over 41 kg, patient has 2 or more mild symptoms of poisoning:
First dose: 1 injection intramuscularly into the mid-lateral thigh

• If patient develops severe symptoms after first dose, give 2 additional injections intramuscularly in rapid succession
• Wait 10 to 15 minutes after first injection, if no severe symptoms develop, no additional injections are recommended.

Severe symptoms in patients over 41 kg:
Give 3 injections intramuscularly in rapid succession in the mid-lateral thigh

ATNAA(R):

• Self or buddy-administer by military personnel after donning protective mask and hood at the first sign of a chemical attack, and only if some or all mild symptoms are present.

Self aid: Administer 1 injection into the lateral thigh muscle or buttocks

• Wait 10 to 15 minutes for antidote to take effect; if you can ambulate and know who and where you are, you do not need a second injection
• If symptoms are not relieved by one injection, seek someone else to check your symptoms; a buddy must administer second and third injections if needed.

Buddy aid: For patients with severe symptoms:

• If one injection (self aid) has been administered, administer 2 more injections in rapid succession into the lateral thigh or buttocks.
• If no medication has been given, administer 3 injections in rapid succession into the lateral thigh or buttocks.

Mild symptoms:

• Blurred vision/miosis
• Excessive, unexplained teary eyes
• Excessive, unexplained runny nose
• Increased salivation such as sudden drooling
• Chest tightness or difficulty breathing
• Tremors throughout the body or muscular twitching
• Nausea and/or vomiting
• Unexplained wheezing, coughing, or increased airway secretions
• Acute onset stomach cramps
• Tachycardia or bradycardia
• Unexplained, sudden headache
• Localized sweating and muscular twitching in the area of contaminated skin

Severe symptoms:

• Strange or confused behavior
• Severe difficulty breathing or copious secretions form lungs/airway
• Severe muscular twitching and general weakness
• Involuntary urination and defection
• Convulsions
• Unconsciousness

Comments:

• Only administer for symptoms where organophosphorous poisoning is known or suspected.
• Administer as soon as possible after appearance of symptoms.

Use(s): Poisoning by organophosphorous nerve agents and organophosphorous insecticides.

Usual Pediatric Dose for Organophosphate Poisoning

DuoDote(R) autoinjector:

Mild symptoms in patients over 41 kg, patient has 2 or more mild symptoms of poisoning:
First dose: 1 injection intramuscularly into the mid-lateral thigh

• If patient develops severe symptoms after first dose, give 2 additional injections intramuscularly in rapid succession
• Wait 10 to 15 minutes after first injection, if no severe symptoms develop, no additional injections are recommended.

Severe symptoms in patients over 41 kg:
Give 3 injections intramuscularly in rapid succession in the mid-lateral thigh

Mild symptoms:

• Blurred vision/miosis
• Excessive, unexplained teary eyes
• Excessive, unexplained runny nose
• Increased salivation such as sudden drooling
• Chest tightness or difficulty breathing
• Tremors throughout the body or muscular twitching
• Nausea and/or vomiting
• Unexplained wheezing, coughing, or increased airway secretions
• Acute onset stomach cramps
• Tachycardia or bradycardia

Severe symptoms:

• Strange or confused behavior
• Severe difficulty breathing or copious secretions form lungs/airway
• Severe muscular twitching and general weakness
• Involuntary urination and defection
• Convulsions
• Unconsciousness

Comments:

• Only administer for symptoms where organophosphorous poisoning is known or suspected.

Use(s): Poisoning by organophosphorous nerve agents and organophosphorous insecticides.

Usual Pediatric Dose for Nerve Agent Poisoning

DuoDote(R) autoinjector:

Mild symptoms in patients over 41 kg, patient has 2 or more mild symptoms of poisoning:
First dose: 1 injection intramuscularly into the mid-lateral thigh

• If patient develops severe symptoms after first dose, give 2 additional injections intramuscularly in rapid succession
• Wait 10 to 15 minutes after first injection, if no severe symptoms develop, no additional injections are recommended.

Severe symptoms in patients over 41 kg:
Give 3 injections intramuscularly in rapid succession in the mid-lateral thigh

Mild symptoms:

• Blurred vision/miosis
• Excessive, unexplained teary eyes
• Excessive, unexplained runny nose
• Increased salivation such as sudden drooling
• Chest tightness or difficulty breathing
• Tremors throughout the body or muscular twitching
• Nausea and/or vomiting
• Unexplained wheezing, coughing, or increased airway secretions
• Acute onset stomach cramps
• Tachycardia or bradycardia

Severe symptoms:

• Strange or confused behavior
• Severe difficulty breathing or copious secretions form lungs/airway
• Severe muscular twitching and general weakness
• Involuntary urination and defection
• Convulsions
• Unconsciousness

Comments:

• Only administer for symptoms where organophosphorous poisoning is known or suspected.

Use(s): Poisoning by organophosphorous nerve agents and organophosphorous insecticides.

Renal Dose Adjustments

Data not available

• Patients with severe renal impairment may require less frequent doses after the initial dose.
• Pralidoxime can cause decreased renal function.

Liver Dose Adjustments

Data not available

• Patients with severe hepatic impairment may require less frequent doses after the initial dose

Precautions

CONTRAINDICATIONS:

• There are no absolute contraindications in the face of life-threatening poisoning by organophosphorous nerve agents

Safety and efficacy have not been established in patients weighing under 41 kg.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available