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Anticholinergic toxicity is commonly seen in the emergency department but is rarely fatal. According to the 2015 annual American Association of Poison Control Centers (AAPCC) report, there were just under 14,000 exposures reported to poison control centers that year, none of which led to mortality.
Anticholinergic toxicity is most likely to occur in the elderly taking anticholinergic drugs due to the fact that most already have suboptimal levels of acetylcholine. In this case, adding a potent anticholinergic to their medication regimen can result in dangerously low levels of acetylcholine.
The basic mechanisms, presentation, and management of anticholinergic poisoning are reviewed here. Discussions of specific agents that can cause an anticholinergic toxidrome and the general approach to the poisoned patient are found separately.
Anticholinergic toxicity is often one component of tricyclic intoxication. An EKG may be helpful in sorting out a pure anticholinergic syndrome versus the combination of an antiholinergic syndrome plus sodium channel blockade. Opsoclonus is rapid involuntary eye movements in all directions.
The antidote for anticholinergic toxicity is physostigmine salicylate. Most patients can be safely treated without it, but it is recommended for those who have tachydysrhythmia with...
Clinical characteristics of anticholinergic toxicity include anhidrosis, anhidrotic hyperthermia, vasodilation-induced flushing, mydriasis, urinary retention, and neurological symptoms, including delirium, agitation, and hallucinations.
The characteristic feature of toxicity at central receptors is agitated delirium. This may include: Restlessness / fidgeting /violent behaviour. Visual hallucinations. Picking at imaginary objects in the air or on the bedsheets. Mumbling / slurred speech. Fluctuating mental status.
Potential symptoms of toxicity categorize into effects on the CNS (coma and seizures), effects on peripheral muscarinic receptors (bradycardia, bronchospasm, gland overactivity, nausea, and vomiting), and effects on peripheral nicotinic receptors (neuromuscular symptoms).
Anticholinergics can treat various health conditions, including urinary incontinence and certain types of poisoning. They can cause side effects due to decreased urination, digestion, and ...
Anticholinergic toxicity is caused by increased accumulation of anticholinergic agents in the body and can lead to anticholinergic syndrome. In higher doses, anticholinergic syndrome can be life threatening and requires immediate medical advice and treatment with acetylcholinesterase inhibitors.