Infant (0 – 2 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 0.05 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.
Infant (0 – 2 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 0.1 mg/kg IM; 2-PAM Cl at 25 mg/kg IM.
Child (2 – 10 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 1 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.
Child (2 – 10 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 2 mg/kg IM; 2-PAM Cl at 25 mg/kg IM.
Adolescent (> 10 yrs), for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 2 mg/kg IM; 2-PAM Cl at 15 mg/kg IM.
Adolescent (> 10 yrs), for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 4 mg IM; 2-PAM Cl at 25 mg/kg IM.
Adult, for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 2 to 4 mg IM; 2-PAM Cl at 600 mg IM.
Adult, for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 6 mg IM; 2-PAM Cl at 1800 mg IM.
Elderly, frail for mild to moderate physical findings, including localized sweating, muscular twitching (fasciculations), nausea, vomiting, weakness, and shortness of breath (dyspnea); administer Atropine at 1 mg IM; 2-PAM Cl at 10 mg/kg IM.
Elderly, frail for severe physical findings, including unconsciousness, convulsions, cessation of breathing (apnea), and floppy (flaccid) paralysis; administer Atropine at 2 to 4 mg IM; 2-PAM Cl at 25 mg/kg IM.
Assisted ventilation should be started after administration of antidotes for severe exposures.
Repeat atropine (2 mg IM for adults or 0.05 to 0.1 mg/kg for children) at 5 to 10 minute intervals until secretions have diminished and breathing is comfortable or airway resistance has returned to near normal.