Which medication would worsen symptoms of sarin poisoning?

Sarin is a highly potent nerve agent that inhibits the enzyme acetylcholinesterase, leading to an accumulation of acetylcholine in the synapses. This results in overstimulation of the cholinergic receptors and an exacerbation of symptoms associated with poisoning, such as salivation, lacrimation, urination, diarrhea, gastrointestinal distress, and muscle twitching.

Carbachol is a non-selective cholinergic agonist that stimulates both muscarinic and nicotinic receptors, thereby promoting the effects of acetylcholine in the body. Administering carbachol during sarin poisoning would further increase the already elevated levels of acetylcholine, worsening symptoms and potentially leading to life-threatening respiratory distress and paralysis.

In contrast, medications like atropine are effective in counteracting the effects of sarin poisoning. Atropine is a muscarinic antagonist that blocks the action of acetylcholine at muscarinic receptors, helping to alleviate symptoms such as bronchoconstriction, excessive salivation, and bradycardia.

Thus, the medication that would worsen the symptoms of sarin poisoning is indeed carbachol, as it would contribute to the overwhelming cholinergic activity caused by the accumulation of acetylcholine.