Final answer:
Neostigmine used with atropine reverses the effects of neuromuscular blocking agents like nerve poisons by inhibiting acetylcholinesterase and preventing excessive acetylcholine build-up; this treatment clears bronchial secretions and, with oximes, also reactivates the poisoned enzyme.
Step-by-step explanation:
Neostigmine is often used with atropine as an anticholinergic to reverse the effects of neuromuscular blocking agents, specifically in the context of anesthesia. These agents include drugs like nerve poisons, such as organophosphorus compounds and carbamates, which disrupt the nervous system by inhibiting the function of the enzyme acetylcholinesterase. This enzyme breakdown is crucial because it prevents the accumulation of acetylcholine in the synapses, thus avoiding continuous nerve impulses and muscle contractions. The endpoint of atropine administration is to clear bronchial secretions, and when combined with oximes such as pralidoxime chloride, it provides a comprehensive treatment strategy by addressing the symptoms and counteracting the toxic agent itself.