A 35-year-old farm worker is brought to the emergency department after collapsing in a greenhouse with known pesticide exposure. Vital signs show BP 92/58, HR 128, RR 24, SpO2 88% on room air. He presents with profuse diaphoresis, excessive salivation, wheezing, vomiting, diarrhea, pinpoint pupils, and visible muscle fasciculations. Serum cholinesterase is markedly decreased at 18% of normal. Recent chest X-ray shows no aspiration. Which of the following is the most appropriate immediate pharmacotherapy?
- A)Flumazenil
- B)Naloxone
- C)Atropine plus pralidoximeGABARITO
- D)N acetylcysteine
- E)Physostigmine
Explicação
Organophosphate poisoning irreversibly inhibits acetylcholinesterase, causing muscarinic excess, nicotinic toxicity, and central symptoms. Atropine rapidly antagonizes muscarinic effects such as bronchospasm and secretions, while pralidoxime regenerates acetyl... Ver explicação completa e trilha adaptativa →