A 78-Year-Old Man Was Found to Have a Perihilar Mass

A 78-year-old man was found to have a perihilar mass on screening CT scan.  The patient's medical history is remarkable for chronic obstructive pulmonary disease, for which he takes albuterol inhalers as needed.  He has smoked a pack of cigarettes daily for the last 50 years and does not drink alcohol or use illicit drugs.  The patient is admitted for bronchoscopy and is premedicated with intramuscular atropine and becomes acutely restless, disoriented, and combative.  Temperature is 38.1 C (100.5 F) , blood pressure is 116/72 mm Hg, pulse is 110/min, and respirations are 15/min.  Oxygen saturation is 99% on room air.  On physical examination, his pupils are widely dilated and nonreactive to light.  ECG shows sinus tachycardia.  Which of the following agents will reverse all of this patient's signs and symptoms?

A) Diazepam
B) Edrophonium
C) Haloperidol
D) Neostigmine
E) Physostigmine

Correct Answer:

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