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Physostigmine salicylate, a centrally acting cholinesterase inhibitor, is effective in rapidly and dramatically reversing the effects produced by anticholinergic drugs. Three case reports of successful use of physostigmine are presented. Since physostigmine is a tertiary amine that allows for passage of the drug into the central nervous system, it can reverse both the peripheral and central nervous system effects of anticholinergic poisoning. The adverse effects and contraindications of physostigmine use are discussed.
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