Anticholinergic overdose

Description

This syndrome may occur as a result of the use of various medicaments, usually antihistamines. Some plants (Datura Stramonium, sage, Brugmansia) may also cause this syndrome. Medicines that can cause this disorder include scopolamine, benztropine, Diphenhydramine, chlorpheniramine, doxylamine, hydroxyzine and meclizine. This overdose can be intentional or accidental.

Symptoms

Intense skin redness, dry skin, impaired vision, confusion, fever, rapid heartbeat, shivering, sudden movements.

Overview

History of disease is being taken and physical examinations are being done. Laboratory and radiologic tests are done to eliminate other possible causers of this syndrome.

Tests

Complete blood count (CBC), biochemical blood analysis, CT scan, electrocardiogram (ECG/EKG), pregnancy test (beta-HCG, troponin, analysis of urine and X-rays.

Additional analyses

Toxicological analysis of urine and blood, creatine phosphokinase (CK).

Specialists

Medical Toxicology

Therapy

The patient is under surveillance and oxygen and intravenous fluids are applied. Giving of sedatives with benzodiazepines (diazepam/benzidine, lorazepam, Xanax) is sometimes necessary. If symptoms are severe, physostigmine could also be included in treatment (physostigmine can be indicated to clarify a diagnosis or alleviate the symptoms in severe cases, but it should be used in agreement with Medical Toxicology Specialist).