Nerve Agent Antidote Kit (NAAK) dosing: how many times may be repeated?

• A. One injection only
• B. May repeat up to three times every 5 minutes
• C. May repeat up to two times every 10-15 minutes
• D. May repeat up to four times every 20 minutes

Answer: (C)

Repeat dosing with a NAAK is limited to two repeats at 10 to 15 minutes apart, for a total of up to three doses. This cadence provides enough antidotal effect to counter ongoing organophosphate symptoms while keeping the risk of toxicity from repeated pralidoxime and anticholinergic effects in check. The initial dose addresses early symptoms, a second dose is given if symptoms persist, and a third dose may be given if still needed. After three doses, seek advanced medical care rather than continuing automatic injections.