Scopolamine treatment with physostigmine

As an inhibitor of plasma (pseudo) cholinesterase, DFP produced only minimal reversal of scopolamine-induced incapacitation. Note the very low plasma ChE levels, with only minor decreases in RBC ChE (Fig. 71). DFP does improve near vision when applied to the eye (David Flarper, unpublished data) suggesting that paralysis of the muscles of visual accommodation is probably peripheral in origin. Persistence of pupillary enlargement (in the face of systemic treatment with physostigmine) may be due to physiological or pK factors, causing limited access to the iris. 

Meshulam, Y. et al. Prophylactic transdermal treatment with physostigmine and scopolamine against soman intoxication in guinea-pigs, J. Appl Toxicol, 15, 263, 1995. 

Crowell EB, Ketchum JS. The treatment of scopolamine induced delirium with physostigmine. Clin Pharmacol Ther. 1967 8 409-414. 

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