A 2-year-old child presents with pinpoint pupils, bradycardia, excessive secretions, bronchospasm and muscle fasciculations after playing in a field recently sprayed with insecticide. The antidote with the highest priority is:
- A Naloxone
- B Atropine sulphate ✓
- C Pralidoxime (2-PAM)
- D Physostigmine
Correct answer: B. Atropine sulphate
Explanation
Organophosphate poisoning causes cholinergic toxidrome via irreversible AChE inhibition. Atropine is the primary antidote blocking muscarinic effects (SLUDGE, bronchospasm); large doses are required until secretions dry. Pralidoxime reactivates AChE if given early (within 24–48 h) and is an important adjunct but Atropine takes priority for life-threatening bronchospasm. Naloxone is for opioid toxicity; physostigmine is a cholinergic agent and is contraindicated.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.