A 29-year-old male farm worker is brought to the emergency department 30 minutes after acute pesticide exposure. He presents with diaphoresis, excessive salivation, abdominal cramping, wheezing, and visible muscle fasciculations. Vital signs show BP 98/62, HR 118, RR 22, SpO2 89%. Serum cholinesterase activity is markedly decreased at 15% of normal. Pupils are pinpoint. He denies recent medication use. Which of the following is the most appropriate immediate antidotal therapy?
- A)Atropine and pralidoximeGABARITO
- B)Dantrolene and bromocriptine
- C)Edrophonium and naloxone
- D)Physostigmine and atropine
- E)Pyridostigmine and glucagon
Explicação
Organophosphates irreversibly inhibit acetylcholinesterase, causing excess muscarinic and nicotinic stimulation. Atropine blocks muscarinic effects, and pralidoxime reactivates acetylcholinesterase if given before aging occurs. Ver explicação completa e trilha adaptativa →