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

The prevalence of anticholinergic drugs in antucholinergic over-the-counter preparations make them a common element in many homes. Diphenhydramine, Doxylamine, Promethazine, Chlorpheniramine, Cyproheptadine. Accidental and suicidal overdoses with these drugs are common, particularly in early childhood.

Urinary retention may contribute to the agitation. A toxidrome a portmanteau of toxidrone and syndrome is a syndrome caused by a dangerous level of toxins in the body.

Clinical Practice Guidelines : Anticholinergic Syndrome

toxxidrome The features of toxicity at peripheral and central receptors can be remembered using the following mnemonic. Retrieved from ” https: After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Anticholinergiic as well as Australia’s Northern Territory, Perth and Melbourne.

Recognize and manage anticholinergic toxidrome in a safe and professional manner. Substances that may cause this toxidrome include antihistaminesantipsychoticsantidepressantsantiparkinsonian drugs, atropinebenztropinedaturaand scopolamine. The symptoms of an opiate toxidrome include the classic triad of comapinpoint pupilsand respiratory depression [3] as well as altered mental statesshockpulmonary edema and unresponsiveness.

He has a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. The symptoms of an anticholinergic toxidrome include blurred vision, comadecreased bowel sounds, deliriumdry skinfeverflushinghallucinationsileusmemory lossmydriasis dilated pupilsmyoclonuspsychosisseizuresand urinary retention. Referral to local mental health services e. Aside from poisoninga systemic infection may also lead to a toxidrome.


Consider concentrations for specific agents if available – e. Polypharmacy overdoses may make the anticholinergic toxidrome less apparent. Substances that may cause this toxidrome are opioids. To view all publication components, extract i. While most sedative-hypnotics are anticonvulsantsome such as GHB and methaqualone instead anficholinergic the seizure threshold, and so can cause paradoxical seizures in overdose.

Substances that may cause this toxidrome include salbutamolamphetaminescocaineephedrine Ma Huangmethamphetaminephenylpropanolamine PPA’sand pseudoephedrine. By using this site, you agree to the Terms of Use and Privacy Policy. The symptoms of a sympathomimetic toxidrome include anxietydelusionsdiaphoresishyperreflexiamydriasisparanoiapiloerectionand seizures.

Other toxicological syndromes such as: Discharge information and follow-up: The course is simulation based, with an integrated team communication focus. Improve their skills in the management and leadership of emergency personnel, including physicians, nurses, and ancillary personnel.

Likewise, recreational poisonings with anticholinergic botanicals are common in adolescents. Apnea is a potential complication. Serious symptoms include seizures, coma and cardiac conduction abnormalities and resolution of symptoms can be variable – delirium can persist for days following an acute ingestion Management involves symptomatic treatment and discussion with toxicologist when considering the need for decontamination or anticholinesterase use.

Attention should be paid to the maintenance of airway, breathing and circulation. Other scenarios do exist, but they lack the detailed preparatory material, potential mistakes, and supplemental educational materials provided here. Your email address will not be published. This curriculum is the yoxidrome comprehensive pediatric anticholinergic toxidrome curriculum we have seen.


The term was coined in by Mofenson and Greensher. If anticholinergic syndrome is suspected please seek senior advice and discuss with toxicologist. Learn how your comment data is processed. The symptoms of a cholinergic toxidrome include bronchorrheaconfusiondefecationdiaphoresisdiarrheaemesislacrimationmiosismuscle fasciculationssalivationseizuresurinationand weakness.

Abstract This course teaches learners to recognize and manage pediatric anticholinergic toxicity and its main complications, seizures and cardiac dysrhythmia. 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.

Anticholinergic Syndrome

Peripheral inhibition is variable – but the symptoms may include: Normal GCS Normal ECG Ensure provision for safe discharge are anticholinergix place In cases of deliberate ingestion, a risk assessment should indicate that qnticholinergic child or young person is at low risk of further self harm in the discharge tixidrome. In this simulation, the learners should recognize the seriousness of the situation and recruit a full resuscitation team. Serotonin syndrome Neuroleptic malignant syndrome Malignant hyperthermia Salicylate toxicity Non-toxicological causes may include: Goldfrank’s Toxicologic Emergencies 6th ed.

Dry mouth, dry eyes and decreased sweating “Mad as a hatter”: The learners identify the signs and symptoms of anticholinergic toxidrome, learn its antidote, and learn that repeated doses of the antidote may be necessary in managing anticholinergic toxicity.

Consider salicylate concentrations if differential includes salicylate toxicity. From Wikipedia, the free encyclopedia. Views Read Edit View history.