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NBME 18 Answers

nbme18/Block 4/Question#25 (reveal difficulty score)
A 56-year-old woman is brought to the ...
Pralidoxime ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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submitted by โˆ—handsome(3)

Direct to the point the author listed DUMBELLS of cholinesterase poisoning, hence PRALIDOXIME as antidote , regenerates AChE if given early. +Atropine as competitive inhibitor

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fhegedus  FA 2020 page 240 states for muscarinic symptoms (DUMBBELSS) give atropine. The pralidoxime, on the other hand, is for the nicotonic effects (muscle weakness mentioned in the q stem). So, in short: DUMBBELSS, give atropine and nicotinic, we give pralidoxime. Another note: atropine crosses BBB; pralidoxime does not! +1

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