A 25-year-old farmer presents with miosis, salivation, lacrimation, bradycardia, and muscle fasciculations after accidental pesticide exposure. Which antidote should be administered FIRST to reverse the immediate life-threatening features?
- A Pralidoxime (2-PAM)
- B Diazepam
- C Atropine in high doses ✓
- D N-acetylcysteine
Correct answer: C. Atropine in high doses
Explanation
In organophosphate poisoning, atropine is the priority first antidote; it competitively blocks muscarinic receptors, rapidly reversing hypersecretions, bronchospasm, and bradycardia that are immediately life-threatening. Atropine is titrated until secretions dry. Pralidoxime (an oxime AChE reactivator) is also given but must be administered before 'aging' occurs; it is complementary and addresses nicotinic/neuromuscular features but is not the first-line emergency step.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.