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Saturday, May 14, 2016

Anticholinergic toxicity and physostigmine

May 12, 2016 - By Adams Z - Edited by Dr. Barrie M
"While the numbers in the aforementioned studies aren’t great and retrospectively gathered, it would seem reasonable to attempt physostigmine to help with diagnosis and therapy in patients considered to have anticholinergic toxicity – with the following caveats:
  • Avoid it’s use in patients with known TCA ingestion
  • Avoid it’s use in individuals with QRS >100 (possible TCA overdose)
  • Make sure the patient is on a monitor
  • For the rare (not noted in the two studies above) instance of symptomatic bradycardia or signs of cholinergic toxicity have atropine available"