NREMT Paramedic Practice

What is a treatment option for cholinergic overdose?

1. Activated charcoal

2. Diazepam

3. Pralidoxime

4. All of the above

The correct answer is: All of the above

In cases of cholinergic overdose, treatment options include activated charcoal, diazepam, and pralidoxime, making the inclusion of all these as potential treatments valid. Activated charcoal is used to absorb toxins present in the gastrointestinal tract if the overdose was recent. Administering activated charcoal can reduce systemic absorption of the cholinergic substance, which is crucial in managing an overdose. Diazepam is often administered to control severe symptoms associated with cholinergic toxicity, such as agitation, seizures, or muscle spasms. It acts as a central nervous system depressant, helping to calm excitability caused by the excess acetylcholine due to the overload at cholinergic sites. Pralidoxime, on the other hand, is an antidote specifically effective against organophosphate poisoning, a common cause of cholinergic overdose. It works by reactivating the enzyme acetylcholinesterase, which has been inhibited, allowing it to break down acetylcholine more effectively, thus alleviating the symptoms of cholinergic excess. The combination of these treatments addresses different aspects of cholinergic toxicity, illustrating the comprehensive approach necessary in such medical emergencies.