Antidote auto-injectors

Antidote Auto-Injectors Meridian Medical Technologies, Inc. (10240 Old Columbia Road, Columbia, MD 21046. Tel. 410-309-1477, or 800-638-8093, FAX 410-309-1475,... 

Rebmaim, T., Clements, B.W., Bailey, J.A., Evans, R.G. (2008). Organophosphate antidote auto-injectors vs. traditional administration a time motion study. J. Emerg. Med. (Epub ahead of print). 

Nerve Agent Antidote Kit (NAAK or MARK I) consists of an atropine auto-injector (2 mg), a pralidoxime chloride auto-injector (2-Pam-Cl, 600 mg), the plastic clip joining the two injectors, and a foam case. The kit serve as a countermeasure to nerve agents, including tabun (GA), sarin (GB), soman (GD), GF, and VX. Military personnel can receive three MARK I for self/buddy aid. Possible side effects of atropine and/or 2-PAM-C1 are deemed insignificant in a nerve agent casualty. Intravenous atropine and 2-PAM-C1 can also be made available. The MARK I kit is manufactured by Survival Technology, Inc., Rockville, Maryland. 

Abbara et al. performed simultaneous quantification of different antidotes (diazepam, pralidoxime and atropine) typically co-administered for the therapy of anticholinesterase poisoning (Table 5) [44], PK data resulting from i.m. drug injection by means of a bi-compartemental auto-injector were calculated from human plasma concentrations measured by LC-ESIMS/MS with MRM settings. Administration of 2 mg atropine sulphate yielded plasma peak concentrations of about 4 ng/ml 15 min after injection. 

In mass casualty situations, intravenous antidotes may not be available. In that case, the intramuscular administration is acceptable. Most Emergency Medical Systems in the United States now stock military Autoinjector units containing atropine and pralidoxime, although kits with pediatric doses may not be available. However, in critical situations, children older than 2 or 3 years of age weighing at least 13 kg might benefit from 2 mg of atropine and 600 mg pralidoxime administered intramuscularly with auto-injectors (7). Experience with the accidental atropine auto-injection in 240 Israeli children unexposed to nerve agents revealed that... 

Convulsive Antidote Nerve Agent (CANA) is a convulsion antidote for nerve agents. CANA is an auto-injector that contains 2ml of diazepam (more commonly known as Valium) as the anticonvulsant. Diazepam is fully approved for this application by the USFDA. It is used only as buddy-aid, never self injected. CANA is a note Q item requiring vault or safe storage. Additionally, this item must be stored at a controlled room temperature of 59-86 degrees Fahrenheit. The shelf life is two years. 

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