Question

A 79-year-old female nursing home resident is found unresponsive. Her nephew, who visited that day, is called and admits to giving the patient some 'generic Benadryl' for her allergies. Which medication is most likely to reverse the patient's delirium?

A. Atropine
B. Naloxone
C. Flumazenil
D. Pralidoxime (2-PAM)
E. Physostigmine

Answer 1

Physostigmine is the most likely medication to reverse the patient's delirium caused by an overdose of an antihistamine like Benadryl due to its property of being a cholinesterase inhibitor that can cross the blood-brain barrier.

Step-by-step explanation:

The medication most likely to reverse the patient's delirium, which is suspected to be due to an overdose of a generic form of Benadryl, is physostigmine. Benadryl is an antihistamine with anticholinergic properties, and physostigmine is a cholinesterase inhibitor that can cross the blood-brain barrier, thus counteracting the anticholinergic effects. Options such as atropine and scopolamine are themselves anticholinergics and would worsen the condition, while naloxone is an opioid antagonist, and flumazenil is a benzodiazepine antagonist, which are not appropriate for this scenario. Pralidoxime (2-PAM) is used to treat nerve agent poisoning and would also not be suitable here.