A 50-year-old man is brought to the emergency department 30 minutes after his farmhand found him on the ground sweating profusely. On arrival, he is lethargic and unable to provide any history. His temperature is 37.5°C (99.5°F), pulse is 42/min, and blood pressure is 95/60 mm Hg. Physical examination shows diaphoresis and excessive salivation. The pupils are pinpoint and unreactive, and significant tearing is noted. Diffuse rhonchi and wheezing are present in the lungs bilaterally. First-line therapy is administered, but the patient remains weak. Treatment with which of the following is most likely to improve this patient's current condition?

Question

A 50-year-old man is brought to the emergency department 30 minutes after his farmhand found him on the ground sweating profusely. On arrival, he is lethargic and unable to provide any history. His temperature is 37.5°C (99.5°F), pulse is 42/min, and blood pressure is 95/60 mm Hg. Physical examination shows diaphoresis and excessive salivation. The pupils are pinpoint and unreactive, and significant tearing is noted.  Diffuse rhonchi and wheezing are present in the lungs bilaterally. First-line therapy is administered, but the patient remains weak.  Treatment with which of the following is most likely to improve this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Organophosphates poisoning management includes atropine, a competitive inhibitor of acetylcholine at the muscarinic receptor (reverses muscarinic symptoms)
Because atropine does not act on nicotinic receptors, it cannot reverse any neuromuscular dysfunction caused by organophosphate poisoning. Pralidoxime, a cholinesterase reactivator, is also effective in treating the nicotinic effects of organophosphates and should be given in addition to atropine.

A 50-Year-Old Man Is Brought to the Emergency Department 30