The effects of atropine, pralidoxime, and lidocaine on nerve–muscle and respiratory function in organophosphate-treated rabbits

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Abstract
Death due to poisoning with organophosphate cholinesterase inhibitors has been attributed to central respiratory depression or to a combination of the central effects and peripheral neuromuscular blockade. Atropine has been reported to be an effective antidote against the central respiratory depression. Pralidoxime and lidocaine will reverse some of the peripheral manifestations of organophosphate cholinesterase inhibitors. Experiments were performed on rabbits to measure the effectiveness of atropine alone or in combination with pralidoxime or lidocaine in reversing the changes produced in neuromuscular and respiratory function by the administration of sarin. Atropine alone will reverse the respiratory arrest produced by sarin without affecting the changes in nerve–muscle function. In the presence of atropine, pralidoxime will reverse all of the peripheral manifestations of cholinesterase inhibition as well as the respiratory arrest produced by sarin administration. Lidocaine will abolish twitch potentiation produced by sarin but enhances the respiratory depression. Respiratory arrest produced by the combination of sarin and lidocaine is reversed by atropine.

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