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An acute anticholinergic syndrome is reversible and subsides once all of the causative agents have been excreted. Reversible acetylcholinesterase inhibitor agents such as physostigmine can be used as an antidote in life-threatening cases. Wider use is discouraged due to the significant side effects related to cholinergic excess including ...
Medications are used to reverse the symptoms of extrapyramidal side effects caused by antipsychotics or other drugs, by either directly or indirectly increasing dopaminergic neurotransmission. The treatment varies by the type of the EPS, but may involve anticholinergic agents such as procyclidine, benztropine, diphenhydramine, and trihexyphenidyl.
Comparison of reversible acetylcholinesterase inhibitors Inhibitor Duration Main site of action Clinical use Adverse effects Edrophonium: short (10 min.) [32] neuromuscular junction [32] diagnosis of myasthenia gravis [32] Neostigmine: medium (1–2 hrs.) [32] neuromuscular junction [32] Reverse neuromuscular block (intravenously) [32]
Indirect acting parasympathomimetic substances may be either reversible cholinesterase inhibitors, irreversible cholinesterase inhibitors or substances that promote ACh release or anti-adrenergics. The latter inhibits the antagonistic system, the sympathetic nervous system. Reversible cholinesterase inhibitors. Donepezil; Edrophonium; Neostigmine
Edrophonium is a readily reversible acetylcholinesterase inhibitor. It prevents breakdown of the neurotransmitter acetylcholine and acts by competitively inhibiting the enzyme acetylcholinesterase, mainly at the neuromuscular junction. It is sold under the trade names Tensilon and Enlon (according to FDA Orange Book).
Physostigmine, an acetylcholinesterase inhibitor, can be used to treat glaucoma and delayed gastric emptying.Because it enhances the transmission of acetylcholine signals in the brain and can cross the blood–brain barrier, physostigmine salicylate is used to treat anticholinergic poisoning (that is, poisoning by substances that interfere with the transmission of acetylcholine signaling, such ...
Cholinergic crisis, sometimes known by the mnemonic "SLUDGE syndrome" (Salivation, Lacrimation, Urination, Defecation, Gastrointestinal distress and Emesis), [4] can be a consequence of: Contamination with - or excessive exposure to - certain chemicals including: nerve agents, (e.g., sarin, VX, Novichok agents).
Anticholinergic drugs have been reported to be extremely effective in 40% of the patients with the Pisa syndrome. [citation needed] Patients with Pisa syndrome that is resistant to anticholinergic drugs is mostly resolved by the reduction of the administration of the antipsychotic drugs as previously mentioned. While the specific pathology ...