Components With Complementary Effects
DuoDote™ contains both atropine and pralidoxime chloride, the 2 antidotes most often recommended in emergency response protocols for organophosphorus nerve agent or organophosphorus insecticide poisoning. [2] They are also the antidotes of choice for the U.S. military and many allied nations around the world. Together, atropine and pralidoxime chloride counteract the effects of an excess buildup of acetylcholine (ACh) — a neurotransmitter that stimulates breathing, intestinal function, vascular function, and muscle movement.

Please click here to learn more about how organophosphorus nerve agents and organophosphorus insecticides block the activity of an enzyme called acetylcholinesterase (AChE), which modulates (ie, deactivates) ACh.

Atropine and pralidoxime chloride exert their effects via completely different, though complementary, mechanisms. First, atropine blocks some of the receptors that ACh binds to in nerve junctions throughout the body, thus reducing the overstimulation of nerve cells by excess quantities of ACh. Then, pralidoxime chloride works to "reactivate" the function of the AChE enzyme, helping to correct the underlying problem of too much ACh in the nerve junctions. [3]

If too much time passes after nerve agent or insecticide poisoning, it becomes more difficult for pralidoxime to reactivate AChE. Therefore, preparedness and rapid response are essential.

History of the Mark I™ Kit
Until 2006, Meridian Medical Technologies supplied emergency first responders with atropine and pralidoxime chloride in 2 separate auto-injectors under the name "Mark I Kit." The 2 components could be carried together in a case called the "NAAK Pak" — an abbreviation for Nerve Agent Antidote Kit.

Since 2003, Meridian has supplied the U.S. military with a single auto-injector containing both atropine and pralidoxime chloride, referred to as "ATNAA" — Antidote Treatment Nerve Agent Auto-Injector. However, ATNAA was ONLY FDA-approved for use by military personnel. Meridian began a development program to make this same technology available for the homeland security market, and in late 2006, the FDA approved DuoDote for use by emergency responders.