Accidental injection of a U.S. Air Force aviator by a pralidoxime chloride auto-injector: a case report

To counter the threat of organophosphate nerve agents, military personnel may be issued auto-injectors containing pralidoxime chloride. This drug helps to dephosphorylate the nerve agent-acetylcholinesterase complex and, thus, regenerate the enzyme. In non-poisoned persons, pralidoxime chloride is rapidly excreted by the kidneys and is fairly well tolerated. We present the first reported case of an accidental injection of an Air Force aviator by an auto-injector. The patient recovered well with no specific treatment needed. The pharmacology and toxicology of pralidoxime chloride are discussed.