A farmer visiting an orchard gets unconscious, excessive salivation, constricted pupils and fasciculation of muscles. Treatment is staed with: AIIMS 07
**Core Concept**
The symptoms described are characteristic of organophosphate poisoning, a type of cholinergic toxicity. This occurs due to the inhibition of acetylcholinesterase, the enzyme responsible for breaking down acetylcholine, a neurotransmitter involved in muscle contraction and other physiological processes.
**Why the Correct Answer is Right**
The correct treatment for organophosphate poisoning involves administering an anticholinergic agent to counteract the effects of excessive acetylcholine. Pralidoxime (2-PAM) is a specific antidote that works by reactivating acetylcholinesterase, thereby reducing the accumulation of acetylcholine in the synaptic cleft. This helps to alleviate the symptoms of cholinergic toxicity, including muscle fasciculation, excessive salivation, and constricted pupils.
**Why Each Wrong Option is Incorrect**
**Option A:** Atropine is an anticholinergic agent, but it is not the initial treatment for organophosphate poisoning. Atropine is used in combination with pralidoxime to manage the symptoms of cholinergic toxicity.
**Option B:** Naloxone is an opioid antagonist used to treat opioid overdoses, not organophosphate poisoning.
**Option C:** Flumazenil is a benzodiazepine antagonist used to treat benzodiazepine overdoses, not organophosphate poisoning.
**Clinical Pearl / High-Yield Fact**
In cases of suspected organophosphate poisoning, it is essential to administer pralidoxime promptly, as delayed treatment can lead to irreversible damage to the nervous system.
**Correct Answer: C. Pralidoxime (2-PAM)**