An individual brought to the emergency department (ED) and is suspected of having taken an overdose of pilocarpine (Pilocar) 3 hours ago
Upon assessment, that nurse notes profuse salivation, lacrimation, bronchospasm, diarrhea, a blood pressure of 82/40, and a heart rate of 51. The nurse should prepare to administer
a. epinephrine (Adrenalin).
b. atropine (Sal-Tropine).
c. activated charcoal.
d. syrup of ipecac.
ANS: B
The patient is showing symptoms of systemic absorption of pilocarpine. Systemic toxicity should be reversed with a muscarinic antagonist, such as atropine.
Epinephrine may be helpful for increasing the heart rate. However, it does not contain anticholinergic properties and would not be the best choice.
Activated charcoal is the preferred method for removing ingested poisons from the gastrointestinal tract.
Syrup of ipecac is not indicated, because it induces vomiting but only removes 30% of the ingested poison even when given early.
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