Florida State Paramedic Practice Exam

If a patient ingests pesticide, which medication is typically administered as the first line of treatment?

1. Activated charcoal

2. Atropine

3. Naloxone

4. Epinephrine

The correct answer is: Atropine

In cases of pesticide ingestion, particularly with organophosphate or carbamate pesticides, the first line of treatment is typically atropine. Atropine acts as an anticholinergic agent that counteracts the effects of acetylcholine accumulation due to the inhibition of the enzyme acetylcholinesterase, which is commonly associated with these types of poisoning. By blocking the action of acetylcholine at muscarinic receptors, atropine helps alleviate symptoms such as excessive salivation, lacrimation, urination, diarrhea, gastrointestinal distress, and bronchoconstriction. Activated charcoal may be administered later to reduce absorption of the pesticide if the ingestion was recent and the patient's airway is protected, but it is not the primary treatment for the acute symptoms caused by pesticide poisoning. Naloxone is specific for opioid overdoses and would not be appropriate here, while epinephrine is used in severe allergic reactions or cardiac arrest but is not indicated for pesticide ingestion unless anaphylaxis is also present. The focus during treatment is on addressing the toxicological effects of the pesticide itself, making atropine the most appropriate choice for initial management.