The current patient had sinus tachycardia at a heart rate of 140 bpm and began to regressĪt the end of the second hour. If it exists, sodium bicarbonate, lidocaine, magnesium or overdrive Monitored and in these cases, sodium bicarbonate can be given.Īnticholinergic drugs may cause ECG changes such as progressive prolongation of PR, QRS, and QT intervals in humans andĪnimals by affecting Ca++, Na+ and especially K+ channels. The right axis or the QRS extension (>100 milliseconds) can be Tachycardia and stability does not require treatment in patients. The most common ECG finding in these patients is sinus Benzodiazepine treatment for seizures can be The current patient was intubated for airway control at the Patients with central nervous system findings or with respiratory insufficiency should be intubated. Stabilisation of cardiac circulation and neurology should be attempted in prehospital care. Įarly treatment of atropine overdose can be life-saving. The dose used in that reported case was twice that takenīy the current patient and the different responses to two different doses indicate that atropine dose response is variable. Of mucous membranes and fever have been observed at highĭoses. However, peripheral effects such as redness on the skin, drying In a case report published in Germany, the patient was mistakenly administered 20mg atropine and no serious central nervous system or respiratory signs were observed. These side-effects canīe seen in a wide range from gastric late emptying to confusion, delirium and coma. Tachycardia, dyspnea, fever, central nervous system findings,Īnd dryness in the mucous membranes. The most common findings due to excessive doses are Side-effects begin to develop at doses ofĥ-10 mg. Normally, the maximum dose is not precisely defined for Ītropine is metabolized mainly in the liver, and half life is 2.5 Intoxications, neuroleptic malignant syndrome and acute psychotic disorder. Sedative hypnotic withdrawal syndrome, postictal status, other Viral encephalitis, Reye’s syndrome, head trauma, alcohol and The differential diagnosis ofĪnticholinergic toxicity includes life-threatening tables such as That case is an interesting example of the use ofĪnticholinergic syndrome should be considered in all patients admitted to ED with unexplained consciousness discomfort because intoxication with anticholinergic effects also occurs High dose of atropine was determined in the blood, urine and Was observed and in the postmortem toxicology examination, a At an autopsy in Germany, atropine intoxication There have been few cases reported in literature of atropine The number of patients with anticholinergic That study, 20,000 patients were examined and no mortal cases The American Association of Poison Control Centers (AAPCC). In 2008,Ī study was conducted with anticholinergic drugs and plants at In general, anticholinergic syndrome can be seen asĪ side-effect in drug mismatches, in older patients due to multiple drug use, or as a side-effect of herbal medicines. The use of atropine for suicide is notĬommon. The most difficult blocking receptor is gastric acid secretion and pancreaticĮxocrine secretion. Smooth muscle are the most affected areas. After counselling by the Psychiatryĭept, the patient was discharged on the 3rd day.Ītropine, a natural belladonna alkaloid, antagonizes acetylcholine at the neuromuscular junction and is a competitiveĪntagonist for cholinergic receptors. Strained at the end of the second hour and at the 4th hour, the As there were determined to be peripheral effects, 0.5mg neostigmine was administered and a midazolam infusion started. Physiostigmine was not available in the hospital, so could not be given. No additional cardiacĭrug was administered because the sinus rhythm was present. Observed any other ECG findings other than sinus tachycardia. Intubated for airway control and transfered to the İntensiveĬare Unit (ICU). After 10 minutes in ED, the respiratory distress andĪgitation of the patient began to increase and the patient was MmHg with a heart rate of 165 beat/minute. Was monitored, and blood pressure was measured as 170/110 Patient had exophthalmus and impaired accommodation. In the first examination findings in ED, the patient was conscious, nervous and tachycardic. Within minutes the patient was brought to theĮmergency Department (ED). A 29-year old male pharmacy staff member self-administered 10mg intravenous atropine in the hospital with the intention of suicide.
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