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.

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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. The symptoms of a hallucinogenic toxidrome include disorientationhallucinationshyperactive bowel sounds, panicand seizures. Improve their skills in the management and leadership of emergency personnel, including physicians, nurses, and ancillary personnel.

The symptoms of an opiate toxidrome include the classic triad of antichollinergicpinpoint pupilsand respiratory depression [3] as well as altered mental statesshockpulmonary edema and unresponsiveness. The use of physostigmine may be indicated following discussion with the toxicology service.

Toxidrome – Wikipedia

There exists some controversy over the use of physostigmine – a cholinesterase inhibitor – which has been used to reduce delirium in anticholinergic syndrome. Treat seizures with benzodiazepines Treat hypoglycaemia Treat hyperthermia with cooling measures. Normal GCS Normal ECG Ensure provision for safe discharge are in place In cases of deliberate ingestion, a anticholunergic assessment should indicate that the child or young person is at low risk of further self harm in the discharge setting.

Some cough medications may also contain paracetamol – so todidrome concentration should be considered in these accidental ingestions as well. 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.


Serotonin syndrome Neuroleptic malignant syndrome Malignant hyperthermia Salicylate toxicity Non-toxicological causes may include: Agitated delirium Urinary retention Hypertension Hyperthermia. The symptoms of an anticholinergic toxidrome include blurred vision, comadecreased bowel sounds, deliriumdry skinfeverflushinghallucinationsileusmemory lossmydriasis dilated pupilsmyoclonuspsychosisseizuresand urinary retention.

Anticholinergic Syndrome

Other toxicological syndromes such as: Pediatric toxidrome simulation curriculum: Your email address will not be published. This site uses Akismet to reduce spam. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. In this simulation, the learners should anticholinerhic the seriousness of the situation and recruit a full resuscitation team.

The primary complications for the team to recognize and manage are seizures and cardiac dysrhythmias. Discharge information and follow-up: All patients with intentional ingestions, should be admitted under the adolescent or psychiatric units. Recognize and manage cardiac dysrhythmias in a safe and professional manner. Learn how your comment data is processed. The features of toxicity at peripheral and central receptors can be remembered using the following mnemonic “Hot as a hare”: From Wikipedia, the free encyclopedia.

Consider concentrations for specific agents if available – e. This page was last edited on 31 Octoberat This curriculum is znticholinergic most comprehensive pediatric anticholinergic toxidrome curriculum we have seen.

This guideline has been adapted for statewide use with the support of the Victorian Paediatric Clinical Network. Consider salicylate concentrations if differential includes salicylate toxicity.

Anticholinergic Toxidrome

Diphenhydramine, Doxylamine, Toxiidrome, Chlorpheniramine, Cyproheptadine. A toxidrome may indicate a medical emergency requiring treatment at a poison control center. Bladder scan will reveal the need for a urinary catheter.


He has a passion for helping clinicians learn and for improving the clinical anticholinergoc of individuals and collectives. By using this site, you agree to the Terms of Use and Privacy Policy. The course is simulation based, with an integrated team communication focus. Risk assessment Anticholinergic syndrome may occur following: Recognize and manage anticholinergic toxidrome in a safe and professional manner.

These children often benefit from 1-to-1 nursing. His one great achievement is being the father of two amazing children. Substances that may cause this toxidrome include salbutamolamphetaminescocaineephedrine Ma Huangmethamphetaminephenylpropanolamine PPA’sand pseudoephedrine.

Polypharmacy overdoses may make the anticholinergic toxidrome less apparent. Central inhibition leads to an agitated hyperactive delirium anticholinergicc typically including confusion, restlessness and picking at imaginary objects – which characterises this toxidrome.

Pediatric Anticholinergic Toxidrome Simulation.

First Aid for the Emergency Medicine Clerkship 2nd ed. Common symptoms include dizzinessdisorientationnauseavomitingand oscillopsia. For 24 hour advice, contact the Victorian Poisons Information Centre on 13 11 On Twitter, he is precordialthump. Recognize and manage seizures in a safe and professional manner. Referral to local mental health services e. While most sedative-hypnotics are anticonvulsantsome such as GHB and methaqualone instead lower the seizure threshold, and so can cause paradoxical seizures in overdose.