Which antidotes are used in field management of organophosphate poisoning?

• A. Naloxone and epinephrine
• B. Atropine and pralidoxime
• C. Vitamin C and diazepam
• D. No antidotes used in field

Answer: (B)

Organophosphate poisoning causes a buildup of acetylcholine by inhibiting acetylcholinesterase, leading to widespread muscarinic and nicotinic effects. In the field, treating these effects requires two antidotes working together: atropine blocks muscarinic receptors, reducing secretions, bronchospasm, and other muscarinic symptoms; pralidoxime reactivates acetylcholinesterase, addressing the nicotinic effects at the neuromuscular junction and helping reverse muscle weakness. This combination targets the main pathways of toxicity and is the standard field approach. Other options aren’t antidotes for organophosphates—naloxone reverses opioids; epinephrine treats certain allergic or respiratory emergencies; vitamin C and diazepam don’t counteract the cholinergic crisis; and it’s not correct to say no antidotes are used in the field.