Which medication is used as an antidote for anticholinergic poisoning?

Physostigmine is the correct antidote for anticholinergic poisoning because it is a reversible inhibitor of the enzyme acetylcholinesterase. This action allows for increased levels of acetylcholine in the synaptic cleft, which competes with the anticholinergic effects seen in poisoning scenarios. In the context of anticholinergic toxicity—often characterized by symptoms like dry mouth, dilated pupils, flushed skin, and confusion—physostigmine acts to counteract these effects by promoting cholinergic effects and restoring balance to the nervous system.

Using physostigmine is particularly significant in cases where patients exhibit extreme symptoms or severe effects, such as delirium or coma, as it can reverse these conditions effectively. The medication is administered carefully, considering potential side effects and contraindications.

Other medications listed are not appropriate for treating anticholinergic poisoning: while atropine can exacerbate anticholinergic symptoms, pralidoxime is mainly used for organophosphate poisoning, and dopamine is utilized in the management of shock and cardiac issues but has no role in antidoting anticholinergic toxicity.