A 47-year-old man is brought to the emergency department 30 minutes after the onset of blurred vision, difficulty
breathing, vomiting, diarrhea, muscle weakness, and fatigue. He is a farmer, and the symptoms began shortly after
he spilled an agricultural chemical on his clothes. His pulse is 30/min, and blood pressure is 90/60 mm Hg. Cheyne-
Stokes respirations are labored with wheezing and gurgling. Further evaluation shows moderate dehydration,
hypoxemia, and hypercapnia. Which of the following is the most appropriate immediate pharmacotherapy for this
patient?
(A) Atropine
(B) Bethanechol
© Epinephrine
(D) Isoproterenol
(E) Physostigmine