Common Nausea, Muscle weakness, Drowsiness, Headache, Dizziness, Double vision, Blurred vision, Increased blood pressure, Hyperventilation, Increased heart rate, Accomodation disturbance.

Expert advice for Pam Injection

Pralidoxime is not effective in the treatment of poisoning due to phosphorus, inorganic phosphates, or organophosphates not having anticholinesterase activity.
Do not take pralidoxime as an antidote for poisoning due to pesticides of carbamate class, as it may increase the toxicity of carbaryl.
You should seek treatment of organophosphate poisoning without waiting for the results of laboratory tests.
Seek for immediate medical attention if you have abnormal heartbeat, difficulty or trouble with breathing, increased muscle weakness, or severe tiredness after receiving this medicine.
Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving pralidoxime.After treatment with pralidoxime, you may be watched for up to 72 hours to make sure that you no longer have any effects of the poison or drug overdose.
Tell your doctor if you are or planning to become pregnant or are breastfeeding.

Q. How does Pam work?
Pam works by reactivating the enzyme acetylcholinesterase, which has been inactivated by pesticides or certain drugs, and breaks down the excess acetylcholine resulting from poisoning. Thus, it helps in reversing muscle weakness or respiratory depression caused by poisoning or drug over dosing.