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obidoxime
V03AB13
Forms & Strengths
- Injection: 250 mg / 1 mL ampoule
Adult Dosing
- Initial: 250 mg IV or IM
- Maintenance: 250 mg every 2-4 hours as needed based on clinical response and reactivation of acetylcholinesterase
Pediatric Dosing
- Initial: 4-8 mg/kg IV or IM
- Maintenance: 1-4 mg/kg every 4-6 hours as clinically indicated
Indications
- Antidote for organophosphate poisoning (insecticides, nerve agents) used in conjunction with atropine
Mechanism of Action
- Oxime quaternary ammonium compound that nucleophilically attacks phosphorylated acetylcholinesterase, reactivating the enzyme and reversing neuromuscular blockade
Contraindications
- Hypersensitivity to obidoxime
- Carbamate insecticide poisoning (may worsen toxicity)
- Non-organophosphate pesticide poisoning
Adverse Reactions
- Transient elevation of liver enzymes
- Tachycardia
- Hypertension
- Nausea and vomiting
- Weakness
- Local pain and inflammation at injection site
Drug Interactions
- Atropine (synergistic effects in organophosphate poisoning; concurrent use is standard)
- Succinylcholine (may have altered neuromuscular blockade duration)
- Aminoglycosides and other neuromuscular blocking agents (potential for additive weakness)
Curated Content: Needs Vetting Before Put to Clinical Use