Atropine antidote2/16/2023 ![]() ![]() Physostigmine is a carbamate that acts by reversibly inhibiting acetylcholinesterase. 4 The antimuscarinic toxidrome results from blockade of the neurotransmitter acetylcholine at central and peripheral muscarinic receptors. 1, 3 Ingestion of as little as a few drops of atropine in eye drop formulation can cause anticholinergic, or more specifically antimuscarinic, toxicity. These phenomena have been described even with attempted therapeutic ophthalmic use. 2 In overdose, atropine can cause tachycardia, agitation, delirium, dilated pupils, dry mucous membranes, dry skin, and hypoactive bowel sounds. It can be administered by various routes, including the eye drop formulation of atropine sulfate, used to induce cycloplegia and mydriasis. 1 It acts as a competitive antagonist of acetylcholine at muscarinic receptors. Atropine, or hyoscyamine, is an alkaloid used commonly for its antimuscarinic properties.
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