What is the treatment for anticholinergic poisoning (such as from insecticides)?

The treatment for anticholinergic poisoning, which can occur due to exposure to certain insecticides or drugs with anticholinergic properties, primarily focuses on reversing the effects of anticholinergic agents. In this context, atropine is often utilized as it acts as a competitive antagonist at muscarinic receptors.

Atropine helps to counteract symptoms such as dry mouth, dilated pupils, flushed skin, and impaired sweating, which are typical manifestations of anticholinergic toxicity. It is especially effective in reversing bradycardia (slow heart rate) and other cardiovascular issues associated with this type of poisoning.

The other options, while they may be used in the management of various medical conditions, do not specifically address the antidotal need for anticholinergic toxicity. For example, physostigmine is an acetylcholinesterase inhibitor that can be used for certain types of poisoning, particularly with central nervous system effects, but it is not the first line of treatment for purely peripheral anticholinergic effects. Benzodiazepines may help with agitation and seizures but do not directly counteract anticholinergic effects. Naltrexone is an opioid antagonist and does not play a role in treating anticholinergic