While transporting a 45-year-old male patient from a rural area, you notice that he is exhibiting excessive salivation, lacrimation, urination, defecation, gastrointestinal upset, and miosis. His coworkers report that he was exposed to a pesticide in the field. What is the most appropriate medication to administer?
The patient's symptoms indicate cholinergic toxicity due to organophosphate pesticide exposure. Atropine is an anticholinergic agent that blocks muscarinic receptors, reducing secretions and reversing bradycardia. It is the first-line treatment in organophosphate poisoning. Naloxone is an opioid antagonist used for opioid overdoses and is not effective in this situation. Calcium gluconate is used for calcium channel blocker overdose and hydrofluoric acid exposure, which are not relevant here. Flumazenil is a benzodiazepine antagonist used for benzodiazepine overdoses and may cause seizures in patients with cholinergic toxicity.
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