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ATNAA

ATNAA(Atropine and Pralidoxime Chloride Injection ) side effects drug center

 

PROFESSIONAL

CONSUMER

SIDE EFFECTS

 

ATNAA Side Effects Center

What Is ATNAA?

ATNAA (atropine and pralidoxime chloride injection) is a combination of a cholinergic muscarinic antagonist and a cholinesterase reactivator used to treat poisoning by susceptible organophosphorus nerve agents having anticholinesterase activity in adults.

What Are Side Effects of ATNAA?

Side effects of ATNAA include:

Dosage for ATNAA

The dosage of ATNAA for mild symptoms is one injection self-administered intramuscularly into the lateral thigh muscle or buttocks. If, at any time after the first dose, the service member develops any of the severe symptoms or if the mild symptoms are not relieved, a buddy should administer two additional injections intramuscularly in rapid succession. The dosage of ATNAA for severe symptoms is to immediately buddy-administer three injections intramuscularly into the service member's lateral thigh muscle or buttocks in rapid succession.

ATNAA In Children

The safety and effectiveness of ATNAA in pediatric patients have not been established.

What Drugs, Substances, or Supplements Interact with ATNAA?

ATNAA may interact with other medicines such as:

  • succinylcholine and
  • mivacurium

Tell your doctor all medications and supplements you use.

ATNAA During Pregnancy and Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant before using ATNAA. Atropine readily crosses the placental barrier and enters fetal circulation. There are no adequate data on the developmental risk associated with the use of atropine, pralidoxime chloride, or the combination in pregnant women. Atropine has been reported to be excreted in human milk. It is not known whether pralidoxime chloride is excreted in human milk. It is unknown how ATNAA would affect a nursing infant. Consult your doctor before breastfeeding.

Additional Information

Our ATNAA (atropine and pralidoxime chloride injection), for Intramuscular Use Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

 

ATNAA Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some of the side effects of atropine and pralidoxime may be similar to the symptoms of poisoning. Your caregivers will watch you closely to determine whether your body is responding well to the medication, or if you are having any serious side effects.

Tell your caregivers right away if you have:

  • pounding heartbeats or fluttering in your chest;
  • chest pain spreading to your jaw or shoulder;
  • trouble swallowing;
  • painful or difficult urination;
  • little or no urination;
  • unusual changes in mood or behavior; or
  • blurred vision, tunnel vision, eye pain, or seeing halos around lights.

Side effects may be more likely in older adults.

Common side effects may include:

  • trouble breathing;
  • dry mouth;
  • dry eyes, vision changes, increased sensitivity to light;
  • nausea, vomiting;
  • fast heartbeats, increased blood pressure;
  • behavior changes, feeling excited or confused;
  • decreased urination;
  • headache, dizziness, drowsiness;
  • muscle weakness;
  • dry skin, rash; or
  • abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for ATNAA (Atropine and Pralidoxime Chloride Injection )

 

ATNAA Professional Information

SIDE EFFECTS

The following serious adverse reactions are described elsewhere in the labeling:

  • Cardiovascular Risks [see WARNINGS AND PRECAUTIONS]
  • Heat Injury [see WARNINGS AND PRECAUTIONS]
  • Acute Glaucoma [see WARNINGS AND PRECAUTIONS]
  • Urinary Retention [see WARNINGS AND PRECAUTIONS]
  • Pyloric Stenosis [see WARNINGS AND PRECAUTIONS]
  • Exacerbation of Chronic Lung Disease [see WARNINGS AND PRECAUTIONS]

The following adverse reactions associated with the use of atropine and pralidoxime chloride were identified in the literature. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Atropine

Because ATNAA contains pralidoxime chloride, which may potentiate the effect of atropine, signs of atropinization may occur earlier than might be expected when atropine is used alone.

Common adverse reactions of atropine can be attributed to its antimuscarinic action. These include dryness of the mouth, blurred vision, dry eyes, photophobia, confusion, headache, dizziness, tachycardia, palpitations, flushing, urinary hesitancy or retention, constipation, abdominal pain, abdominal distention, nausea and vomiting, loss of libido, and impotence. Anhidrosis may produce heat intolerance and impairment of temperature regulation in a hot environment. Dysphagia, paralytic ileus, acute angle closure glaucoma, maculopapular rash, petechial rash, and scarletiniform rash have also been reported. Adverse cardiac reactions, including arrhythmias and myocardial infarction, have been reported with atropine [see WARNINGS AND PRECAUTIONS and CLINICAL PHARMACOLOGY].

Larger doses of atropine may produce central nervous system effects such as restlessness, tremor, fatigue, locomotor difficulties, delirium, and hallucinations [see OVERDOSE].

Hypersensitivity reactions will occasionally occur; these are usually seen as skin rashes, and may progress to exfoliation. Anaphylactic reaction and laryngospasm are rare.

Pralidoxime Chloride

Pralidoxime chloride can cause blurred vision, diplopia and impaired accommodation, dizziness, headache, drowsiness, nausea, tachycardia, increased systolic and diastolic blood pressure [see CLINICAL PHARMACOLOGY], muscular weakness, dry mouth, emesis, rash, dry skin, hyperventilation, decreased renal function, and decreased sweating when given parenterally to normal adult volunteers who have not been exposed to anticholinesterase poisons.

In several cases of organophosphorus poisoning, excitement and manic behavior have occurred immediately following recovery of consciousness, in either the presence or absence of pralidoxime chloride administration. However, similar behavior has not been reported in subjects given pralidoxime chloride in the absence of organophosphorus poisoning.

Elevations in AST and/or ALT enzyme levels were observed in 1 of 6 normal adult volunteers given 1200 mg of pralidoxime chloride intramuscularly, and in 4 of 6 adult volunteers given 1800 mg intramuscularly. Levels returned to normal in about two weeks. Transient elevations in creatine kinase were observed in all normal volunteers given the drug.

Injection Site

Muscle tightness and pain may occur at the injection site.

Inadvertent Injection

In cases where ATNAA is inadvertently administered to service members who are not poisoned with susceptible organophosphorus nerve agents having anticholinesterase activity, the following effects on their ability to function normally may occur.

Atropine 2 mg IM, roughly the equivalent of one ATNAA injection, when given to healthy male volunteers, is associated with minimal effects on visual, motor, and mental functions, though unsteadiness walking and difficulty concentrating may occur. Atropine reduces body sweating and increases body temperature, particularly with exercise and under hot conditions.

Atropine 4 mg IM, roughly the equivalent of two ATNAA injections, when given to healthy male volunteers, is associated with impaired visual acuity, visual near point accommodation, logical reasoning, digital recall, learning, and cognitive reaction time. Ability to read is reduced or lost. Subjects are unsteady and need to concentrate on walking. These effects begin about 15 minutes to one hour or more post-dose.

Atropine 6 mg IM, roughly the equivalent of three ATNAA injections, when given to healthy male volunteers, is associated with the effects described above plus additional central effects including poor coordination, poor attention span, and visual hallucinations (colored flashes) in many subjects. Frank visual hallucinations, auditory hallucinations, disorientation, and ataxia occur in some subjects. Skilled and labor-intense tasks are performed more slowly and less efficiently. Decision making takes longer and is sometimes impaired.

It is unclear if the above data, obtained from studies of healthy male subjects, can be extrapolated to other populations. In the elderly and individuals with co-morbid conditions, the effects of ≥2 mg atropine on the ability to see, walk, and think properly are unstudied; effects may be greater in susceptible populations.

Service members who are mistakenly injected with ATNAA should avoid potentially dangerous overheating, avoid vigorous physical activity, and seek medical attention as soon as feasible.

Read the entire FDA prescribing information for ATNAA (Atropine and Pralidoxime Chloride Injection )

© ATNAA Patient Information is supplied by Cerner Multum, Inc. and ATNAA Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.