Question

A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As one component of her treatment, she receives a dose of physostigmine.

Refer to the case above. Physostigmine is preferred over neostigmine because
A) it is a nonpolar compound that penetrates the CNS more easily than neostigmine.
B) it has a shorter half-life than neostigmine, making it more useful for emergency treatment.
C) it has a longer half-life than neostigmine, better matching the half-life of atropine.
D) it is eliminated via the kidneys, and dosage is not critical with compromised liver function.
E) it is eliminated via the liver, and dosage is not critical with compromised renal function.

Answer 1

Physostigmine is preferred over neostigmine for treating central anticholinergic intoxication because it is nonpolar, enabling it to cross the blood-brain barrier and reverse the toxic effects in the CNS.

Step-by-step explanation:

The reason physostigmine is preferred over neostigmine in the treatment of central anticholinergic intoxication, such as that caused by the ingestion of Atropa belladonna, which contains atropine, is that physostigmine is a nonpolar compound. This nonpolarity allows it to penetrate the central nervous system (CNS) more readily than neostigmine. Physostigmine works as a cholinesterase inhibitor, reversing the anticholinergic effects by preventing the breakdown of acetylcholine, thereby allowing it to act against the toxic effects of atropine.