Doses - PRALIDOXIME CHLORIDE, 2-PAM CHLORIDE
Note: often used in conjunction with atropine; refer to that monograph and/or the references below for more information.Dogs & Cats:
For organophosphate poisoning:
a) Pralidoxime works best when combined with atropine. Pralidoxime at 20 mg/kg 2-3times a day. Initial dose may be given either IM or slow IV. Subsequent doses may begiven IM or SQ. (Note: Refer to reference for more specific guidelines regarding adjunctive therapy). (Fikes 1990)
b) 20 mg/kg IV bid (Grauer and Hjelle 1988c)
c) 10 - 15 mg/kg IM or SubQ two - three times daily and continued until recovery. Mostbeneficial when started within 24 hours of exposure. (Hansen 1995)
d)Dogs:
50 mg/kg; Cats 20 mg/kg. Give IV slowly or with fluids over a 30 minute period.
Repeat in one hour if symptoms persist and then q8h for 24-48 hours. Authorrecommends using pralidoxime in animals who are severely depressed, weak, andanorectic one or more days after exposure if not previously treated with pralidoxime. Inanimals who have clinical signs intensified (e.g., respiratory depression), reduce doseand give as repeated one hour infusions every 4-8 hours in combination with atropine(0.04 - 0.4 mg/kg) once or prn. (Mount 1989)
e) Cats: 20 mg/kg IM or IV within first 24 hours of exposure. May repeat q6-8h andcombine with atropine or give separately. Do not use in carbamate toxicity. (Reid and Oehme 1989)Cattle:
For organophosphate poisoning:
a) 25 - 50 mg/kg as a 20% solution IV over 6 minutes; or as a maximum of 100mg/kg/day as an IV drip. (Smith 1986)Horses:
For organophosphate poisoning:
a) 20 mg/kg (may require up to 35 mg/kg) IV and repeat q4-6h. (Oehme 1987c)
Monitoring Parameters - Monitoring of pralidoxime therapy is basically by monitoring the signsand symptoms associated with organophosphate poisoning. For more information, refer to one ofthe references outlined noted below.
Client Information - This agent should only be used with close professional supervision.
Dosage Forms/Preparations/FDA Approval Status/Withholding Times - Veterinary-Approved Products: None
Chloride® (Survival Technology) (Rx)
Dogs & Cats: 
For organophosphate poisoning: a) Pralidoxime works best when combined with atropine. Pralidoxime at 20 mg/kg 2-3times a day. Initial dose may be given either IM or slow IV. Subsequent doses may begiven IM or SQ. (Note: Refer to reference for more specific guidelines regarding adjunctive therapy). (Fikes 1990)
b) 20 mg/kg IV bid (Grauer and Hjelle 1988c)
c) 10 - 15 mg/kg IM or SubQ two - three times daily and continued until recovery. Mostbeneficial when started within 24 hours of exposure. (Hansen 1995)
d)
Dogs:
50 mg/kg; Cats 20 mg/kg. Give IV slowly or with fluids over a 30 minute period. Repeat in one hour if symptoms persist and then q8h for 24-48 hours. Authorrecommends using pralidoxime in animals who are severely depressed, weak, andanorectic one or more days after exposure if not previously treated with pralidoxime. Inanimals who have clinical signs intensified (e.g., respiratory depression), reduce doseand give as repeated one hour infusions every 4-8 hours in combination with atropine(0.04 - 0.4 mg/kg) once or prn. (Mount 1989)
e) Cats: 20 mg/kg IM or IV within first 24 hours of exposure. May repeat q6-8h andcombine with atropine or give separately. Do not use in carbamate toxicity. (Reid and Oehme 1989)
Cattle: 
For organophosphate poisoning: a) 25 - 50 mg/kg as a 20% solution IV over 6 minutes; or as a maximum of 100mg/kg/day as an IV drip. (Smith 1986)
Horses: 
For organophosphate poisoning: a) 20 mg/kg (may require up to 35 mg/kg) IV and repeat q4-6h. (Oehme 1987c)
Monitoring Parameters - Monitoring of pralidoxime therapy is basically by monitoring the signsand symptoms associated with organophosphate poisoning. For more information, refer to one ofthe references outlined noted below.
Client Information - This agent should only be used with close professional supervision.
Dosage Forms/Preparations/FDA Approval Status/Withholding Times - Veterinary-Approved Products: None
Human-Approved Products:
Pralidoxime Chloride 1 gram cake in containers of six 20 ml vials without diluent or syringes;600 mg in one 2 ml auto-injector; Protopam Chloride® (Wyeth-Ayerst); (Rx); PralidoximeChloride® (Survival Technology) (Rx)