NREMT Paramedic Practice

What is a common treatment option for anticholinergic overdose?

1. Pralidoxime

2. Physostigmine

3. Atropine

4. Activated charcoal

The correct answer is: Physostigmine

Physostigmine is a common treatment option for anticholinergic overdose because it is an acetylcholinesterase inhibitor that increases the levels of acetylcholine in the synaptic cleft. Anticholinergic agents work by blocking the action of acetylcholine at both central and peripheral muscarinic receptors, leading to symptoms such as confusion, agitation, increased heart rate, and dilated pupils. By inhibiting the enzyme that breaks down acetylcholine, physostigmine counteracts these effects and restores balance to cholinergic activity in the nervous system. It is particularly effective in reversing the central nervous system effects of anticholinergic toxicity, making it an important antidote in acute settings. Other treatments like activated charcoal may be used for managing various overdoses but do not specifically address the underlying mechanisms of anticholinergic toxicity. Pralidoxime is used for organophosphate poisoning, which involves a different pathway. Atropine, while it is an anticholinergic itself, would not be appropriate in this scenario as it would exacerbate the condition rather than treat it.