Which medication should be readily available to treat a bethanechol-induced cholinergic crisis?

Which medication should be readily available to treat a bethanechol-induced cholinergic crisis?

• A. Atropine sulfate (Isopto Atropine)
• B. Epinephrine hydrochloride (Adrenalin chloride)
• C. Diphenhydramine hydrochloride (Benadryl)
• D. Acetaminophen (Tylenol)

Answer: (A)

Bethanechol overstimulates muscarinic receptors, so a cholinergic crisis presents with increased salivation, tearing, urination, bronchorrhea/bronchospasm, bradycardia, and miosis. To counteract these muscarinic effects quickly, a muscarinic antagonist is used. Atropine blocks acetylcholine at the muscarinic receptors, reversing the excess parasympathetic stimulation and rapidly alleviating the dangerous symptoms such as bradycardia and bronchorrhea. That makes it the appropriate emergency treatment to have readily available. The other options don’t target muscarinic overactivity—epinephrine helps with certain emergencies like severe allergic reactions or hypotension, while diphenhydramine and acetaminophen address allergy symptoms or pain/fever, not cholinergic toxicity.

Bethanechol overstimulates muscarinic receptors, so a cholinergic crisis presents with increased salivation, tearing, urination, bronchorrhea/bronchospasm, bradycardia, and miosis. To counteract these muscarinic effects quickly, a muscarinic antagonist is used. Atropine blocks acetylcholine at the muscarinic receptors, reversing the excess parasympathetic stimulation and rapidly alleviating the dangerous symptoms such as bradycardia and bronchorrhea. That makes it the appropriate emergency treatment to have readily available. The other options don’t target muscarinic overactivity—epinephrine helps with certain emergencies like severe allergic reactions or hypotension, while diphenhydramine and acetaminophen address allergy symptoms or pain/fever, not cholinergic toxicity.