Atropine Absorption after Administration with 2-Pralidoxime Chloride by Automatic Injector

摘要

The authors tested the hypothesis that injection of citrated atropine and pralidoxime chloride into a single intramuscular site by a multichambered autoinjector (MCP) would deliver atropine as effectively as the currently fielded MARK I device which injects the two drugs into separate intramuscular sites. 20 non-smoking healthy active duty male soldiers (ages 20-30) were injected in a bare upper leg with the MARK I and with the MCP devices, one week apart, in a crossover study design. Atropine absorption was assessed by serum atropine levels (measured by radioimmunoassay and by radioreceptor assay) and by physiological effect (decreased salivary secretion, heart rate changes, mydriasis, and loss of near vision accommodation). These parameters were observed at specific time points over a 12 hour period following injection while the subjects were kept at bed rest. The authors found that atropine absorption was more rapid following injection by the MARK I with significantly greater changes at 10 minutes for serum atropine, decrease in salivary secretion, and increase in heart rate. Serum levels of atropine peaked at the first time interval (3 minutes) in seven subjects following injection by the MARK I. In contrast, blood pralidoxime chloride levels were significantly higher at 10 minutes following injection by the MCP. Differences between injectors were not apparent at time points beyond the first 30-40 minutes and there was no difference in peak effect or time to peak effect.