To expand further, atropine is used to reverse MUSCARINIC symptoms (i.e. "DUMBBELSS": Diarrhea, Urination, Miosis, Bradycardia, Bronchospasm, Emesis, Lacrimation, Salivation, Sweating) and it can also cross the BBB to relieve the CNS symptoms (i.e. respiratory depression, lethargy, seizures, coma). However, pralidoxime is used to reverse NICOTINIC symptoms (i.e. the neuromuscular blockade). Pralidoxime CANNOT cross the BBB and therefore cannot relieve CNS symptoms. And always give atropine before pralidoxime because pralidoxime can cause transient acetylcholinesterase inhibition, which will worsen the symptoms.
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