Many medications may have anticholinergic effects and interaction between Polypharmacy overdoses may make the anticholinergic toxidrome less apparent. Discussions of specific agents that can cause an anticholinergic toxidrome and the general approach to the poisoned patient are found. Anticholinergic Syndrome. Anticholinergic Syndrome. by Chris Nickson, Last updated January 13, AGENTS. anti-histamines; anti-parkinsonians.

Author: Mazshura Kazrajas
Country: Maldives
Language: English (Spanish)
Genre: Sex
Published (Last): 25 August 2008
Pages: 363
PDF File Size: 2.28 Mb
ePub File Size: 4.7 Mb
ISBN: 702-5-63012-961-6
Downloads: 4296
Price: Free* [*Free Regsitration Required]
Uploader: Malazshura

Substances that may cause this toxidrome are opioids. For 24 hour advice, contact the Victorian Poisons Information Centre on 13 11 26 Background Anticholinergic syndrome results from competitive antagonism of acetylcholine at central and peripheral muscarinic receptors.

Prior to discharge, all children require: Improve their skills in the management and leadership of emergency personnel, including physicians, nurses, and ancillary personnel. The symptoms of a cholinergic toxidrome include bronchorrheaconfusiondefecationdiaphoresisdiarrheaemesislacrimationmiosismuscle fasciculationssalivationseizuresurinationand weakness.

Disclosures None to report. Views Read Edit View history. Bladder scan will reveal the need for a urinary catheter. Complications include hypertensiontoxidrokeand tachypnea. Retrieved from ” https: The prevalence of anticholinergic drugs in many over-the-counter preparations make them a common element in many homes. Complications include hypertensionand tachycardia.

Anticholinergic Toxidrome

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Toxidrime. He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. The symptoms of a sympathomimetic toxidrome include anxietydelusionsdiaphoresishyperreflexiamydriasisparanoiapiloerectionand seizures.


Tachycardia Flushed face Mydriasis and blurred vision Dry mouth and skin Fever.

The toxidromme complications for the team to recognize and manage are seizures and cardiac dysrhythmias. Dry mouth, dry eyes and decreased sweating “Mad as a hatter”: The features of toxicity at peripheral and central receptors can be remembered using the following mnemonic “Hot as a hare”: Goldfrank’s Toxicologic Emergencies 6th antichoilnergic.

Substances that may cause this toxidrome include salbutamolamphetaminescocaineephedrine Ma Huangmethamphetaminephenylpropanolamine PPA’sand pseudoephedrine. The symptoms of an anticholinergic toxidrome include blurred vision, comadecreased bowel sounds, deliriumdry skinfeverflushinghallucinationsileusmemory lossmydriasis dilated pupilsmyoclonuspsychosisseizuresand urinary retention.

Recognize and manage anticholinergic toxidrome in a toxidtome and professional manner. Attention should be paid to the maintenance of airway, breathing and circulation.

The use of physostigmine may be indicated following discussion with the toxicology service. Peripheral inhibition is variable – but the symptoms may include: Apnea is a potential complication. The symptoms of an opiate toxidrome include the classic triad of comapinpoint pupilsand respiratory depression [3] as well as altered mental anticholunergicshockpulmonary edema and unresponsiveness. Common symptoms include dizzinessdisorientationnauseavomitingand oscillopsia. This resource can be used in isolation or as a component of our pediatric toxidrome simulation curriculum to provide more comprehensive pediatric toxicology and resuscitation training.

Anticholinergic Syndrome

This curriculum is the most comprehensive pediatric anticholinergic toxidrome anyicholinergic we have seen. Polypharmacy overdoses may make the anticholinergic toxidrome less apparent. Diphenhydramine, Doxylamine, Promethazine, Chlorpheniramine, Cyproheptadine. Encephalitis Sepsis Neurotrauma Post-ictal phenomena Hypoglycaemia Hyponatraemia Behavioural disturbance Investigations Screening tests – 12 lead ECG, blood glucose and paracetamol concentration – in deliberate self-poisoning.


This guideline has been adapted for statewide use with the support of the Victorian Paediatric Clinical Network. There exists some controversy over the use of physostigmine – a cholinesterase inhibitor – which has been used to reduce delirium in anticholinergic syndrome.

Anticholinergic Toxidrome • LITFL

This page was last edited on 31 Octoberat Your email address will not be published. The course is simulation based, with an integrated team communication focus. On Twitter, he is precordialthump.

It may appear very similar to the anticholinergic toxidrome, but is distinguished by hyperactive bowel sounds and sweating. Anticholinergic syndrome results from competitive antagonism of acetylcholine at central and peripheral muscarinic receptors. A toxidrome a portmanteau of toxic and syndrome is a syndrome caused by a dangerous level of toxins in the body.

There are many types of drugs and botanicals with anticholinergic effects, including diphenhydramine, tricyclic antidepressants, antihistamines, scopolamine, jimsonweed, and belladonna alkaloids.