A 52-year-old pesticide worker exposed to organophosphate presents with excessive salivation, wheezing, and marked skeletal muscle weakness with visible fasciculations. Vital signs show HR 58 bpm, BP 102/64 mmHg, RR 16/min, SpO2 98% on room air. After atropine administration, salivation and bronchospasm resolve, but muscle weakness persists. Serum cholinesterase activity is markedly decreased at 35% of normal. Pupillary constriction remains unchanged. Which medication most directly reverses the enzyme inhibition causing these persistent neuromuscular findings?
- A)Scopolamine
- B)Edrophonium
- C)PralidoximeGABARITO
- D)Succinylcholine
- E)Pilocarpine
Explicação
Pralidoxime reactivates acetylcholinesterase if given before the phosphorylated enzyme ages. It improves both nicotinic and muscarinic manifestations, making it especially useful when weakness and fasciculations persist after atropine. Ver explicação completa e trilha adaptativa →