Final answer:
Physostigmine is the cholinesterase inhibitor that acts both centrally and peripherally and is used to treat anticholinergic toxicity from atropine.
Step-by-step explanation:
The cholinesterase inhibitor that acts both centrally and peripherally to treat anticholinergic toxicity from atropine is physostigmine. Physostigmine is a reversible cholinesterase inhibitor that can cross the blood-brain barrier, hence affecting both the central and peripheral nervous system. It works by preventing the breakdown of the neurotransmitter acetylcholine, thereby countering the effects of atropine by increasing the level of acetylcholine. Treatment for anticholinergic toxicity typically involves the administration of an anticholinergic like atropine to manage symptoms and an oxime, such as pralidoxime chloride (2-PAMCI), to deactivate the poisoning substance and reactivate acetylcholinesterase. However, physostigmine is specifically used for atropine toxicity because of its ability to act centrally.
The antidote for atropine poisoning is a muscarinic agonist, with pilocarpine being an example. Pilocarpine is another drug that can address atropine overdose by activating muscarinic receptors, which atropine blocks. In cases of anticholinergic poisoning, where central symptoms are present, physostigmine would be the preferred treatment option.