Drug NOT given in organophosphorous poisoning: September 2012
**Core Concept**
Organophosphorus poisoning is a medical emergency caused by the inhibition of acetylcholinesterase, leading to an accumulation of acetylcholine in the nervous system. The treatment involves the administration of antidotes that counteract the effects of organophosphates.
**Why the Correct Answer is Right**
Atropine is the drug of choice in organophosphorus poisoning. It works by competitively blocking acetylcholine receptors in the central and peripheral nervous system, thereby countering the effects of excessive acetylcholine. Atropine's anticholinergic properties help to alleviate symptoms such as bradycardia, excessive salivation, and bronchospasm.
**Why Each Wrong Option is Incorrect**
**Option A:** Pralidoxime (2-PAM) is actually given in organophosphorus poisoning, not withheld. It reactivates acetylcholinesterase by breaking the covalent bond between the enzyme and the phosphate moiety.
**Option B:** Pilocarpine is not used in organophosphorus poisoning. In fact, it's an anticholinergic agent that would exacerbate the symptoms of organophosphate poisoning.
**Option C:** Diazepam is sometimes used as a muscle relaxant in the management of organophosphorus poisoning, but it's not the correct answer because it's not the primary treatment. However, diazepam can be used to manage seizures and muscle spasms.
**Clinical Pearl / High-Yield Fact**
In organophosphorus poisoning, always remember the "Atropine-2-PAM" combination as the cornerstone of treatment. This will help you differentiate between the correct and incorrect options.
**Correct Answer: B. Pilocarpine**