Pralidoxime Chloride Injection

Chlorfenapyr is prone to hydrolysis reactions in alkaline solutions, producing inactive decomposition products that lead to reduced efficacy. Do not mix with alkaline drugs such as sodium bicarbonate to avoid drug degradation caused by pH changes. It needs to be separately configured with Chlorfenapyr Injection to avoid sharing the infusion channel with other drugs. Neutral solvents should be used during the preparation process to ensure that the pH value of the solution is maintained within the range of 5-7.

It has significant therapeutic effects on most organophosphate insecticides such as internally absorbed phosphorus and parathion poisoning. Restore nerve conduction function by reviving inhibited cholinesterase activity.
Cases with limited therapeutic efficacy. It has poor toxic effects on malathion, dichlorvos, dichlorvos, dimethoate, mevalonate, propafenone, and octamethoxam. There is no reactivation effect on acetylcholinesterase inhibited by carbamate insecticides.

Inhibition of cholinesterase by organophosphate insecticides for 36 hours resulted in significant revival effect. The mechanism of efficacy attenuation is that after more than 36 hours, acetylcholinesterase undergoes an "aging" phenomenon, and the phosphorylated groups in its active center form stable covalent bonds with the enzyme protein, resulting in ineffective binding of chlorfenapyr. After being diagnosed with organophosphate poisoning, chlorfenapyr should be used immediately to avoid delaying treatment. Regular testing of blood cholinesterase activity is required. When the activity returns to 50% -60% of the normal value, adjustments to the medication regimen may be considered.

It has a significant improvement effect on nicotine like symptoms (such as muscle tremors and muscle weakness), but has a weaker improvement effect on muscarinic symptoms (such as drooling and sweating) and central nervous system symptoms (such as coma and convulsions). According to the specific symptoms of the patient, atropine or other symptomatic supportive drugs should be used in combination. Establish comprehensive evaluation indicators including symptom scoring, cholinesterase activity, and vital signs.

The content of oxime compounds in chlorfenapyr is 79.5%, significantly higher than the 51.9% in iodothyroxine. The efficacy of 1g Chlorfenapyr is equivalent to 1.5g Iodinapyr. Under the same therapeutic effect, the required dose of chlorfenapyr is smaller, which can reduce the injection volume and frequency. Lower doses can help reduce the incidence of drug-related adverse reactions.

The intravenous injection rate should be controlled at no more than 500mg per minute to avoid adverse reactions. Injecting too quickly can cause sympathetic nervous system excitement symptoms such as nausea, vomiting, and increased heart rate. In severe cases, central nervous system symptoms such as dizziness, headache, diplopia, blurred vision, and uncoordinated movements may occur. It is recommended to use intravenous injection for the first administration, and intravenous drip can be chosen for subsequent maintenance treatment. Use an infusion pump to precisely control the drug delivery rate and equip it with electrocardiogram monitoring equipment to monitor the patient's vital signs in real time.

The main basis for discontinuing medication is the complete disappearance of nicotine like symptoms (muscle tremors, muscle weakness). The activity of blood cholinesterase should be maintained at 50% -60% or above of the normal value. Due to the slow absorption and long excretion cycle of organic phosphorus in the digestive tract, treatment needs to be maintained for 48-72 hours. Symptom assessment and cholinesterase activity testing should be conducted every 6 hours.

Compound Chlorfenapyr Injection (Chlorfenapyr Injection) is composed of Chlorfenapyr, Benazepine Hydrochloride, and Atropine Sulfate. Chlorfenapyr revives acetylcholinesterase activity, atropine antagonizes acetylcholine receptors, and benazepril enhances central anticholinergic effects. A single injection can achieve multiple treatment goals and reduce the frequency of nursing operations. By combining interventions with different targets, the success rate of treating organophosphate poisoning can be significantly improved.