A patient with severe atropine poisoning presenting with delirium, hyperthermia, and seizures is treated with a cholinesterase inhibitor that crosses the blood-brain barrier. Which drug is specifically indicated for the central anticholinergic manifestations in this patient?
- A Physostigmine ✓
- B Pyridostigmine
- C Neostigmine
- D Edrophonium
Correct answer: A. Physostigmine
Explanation
Physostigmine is a tertiary amine cholinesterase inhibitor that crosses the blood-brain barrier, making it effective for central anticholinergic manifestations (delirium, seizures) in atropine poisoning. Neostigmine, pyridostigmine, and edrophonium are quaternary ammonium compounds that do not cross the blood-brain barrier and thus cannot reverse central toxicity.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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