Toxin:: [[Anticholinergic toxicity|anticholinergic syndrome]] - reversible acetylcholinesterase inhibitor useful in tx of central anticholinergic delirium - can use for central antimuscarinic effects (agitated delirium) not easily controlled with benzos for an *isolated* anticholinergic agent poisioning (eg atropine, benztropine) **contraindications** - bradyarrhythmias - QRS > 100 ms - AV block - bronchospasm **adverse effects** [[Cholinergic syndrome]] effects: - seizures - bradycardia, HB - bronchosasm **dose** 0.5-1mg slow IV push over 5 min can repeat Q10 min endpoint: resolution of delirium