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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Consider salicylate concentrations if differential includes salicylate toxicity. Substances that may cause this toxidrome include salbutamolamphetaminescocaineephedrine Ma Huangmethamphetaminephenylpropanolamine PPA’sand pseudoephedrine. This site uses Akismet to reduce spam. Urinary retention may contribute to the agitation.

Anticholinergic Syndrome

Attention should be paid to the maintenance of airway, breathing and circulation. Referral to local mental health services e. Anticholinergic syndrome results from competitive antagonism of acetylcholine at central and peripheral muscarinic receptors. We use cookies to understand site usage and to improve the content and offerings on our sites. Your email address will not be published. Complications include bradycardiahypotensionand hypothermia.

Pediatric toxidrome simulation curriculum: For 24 hour advice, contact the Victorian Poisons Information Centre on 13 11 Medical emergencies Medical terminology Toxicology Substance intoxication Medical mnemonics. A toxidrome a portmanteau of toxic and syndrome is a syndrome caused by a dangerous level of toxins in the body. This page was last edited on 31 Octoberat On Twitter, he is precordialthump.

The features of toxicity at peripheral and central receptors can be remembered using the following mnemonic “Hot as a hare”: There are many types of drugs and botanicals with anticholinergic effects, including diphenhydramine, tricyclic antidepressants, antihistamines, scopolamine, jimsonweed, and belladonna alkaloids.


The use of physostigmine may be indicated following discussion with the toxicology service. Substances that may cause this toxidrome include anticonvulsantsbarbituratesbenzodiazepinesgamma-Hydroxybutyric acidMethaqualoneand ethanol.

He has a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. Parent information sheet from Victorian Poisons Information centre on the prevention of poisoning. Agitated delirium Urinary retention Hypertension Hyperthermia.

While most sedative-hypnotics are anticonvulsantsome such as GHB and methaqualone instead lower the seizure threshold, and so can cause paradoxical seizures in overdose.

Recognize and manage seizures in a safe and professional manner. Accidental and suicidal overdoses with these drugs are common, particularly in early childhood. After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Anticholinegic and Melbourne.

Complications include hypertensiontachycardiaand tachypnea. Pediatric Clinics of North America.

Toxidrome – Wikipedia

Substances that may cause this toxidrome include antihistaminesantipsychoticsantidepressantsantiparkinsonian drugs, atropinebenztropinedaturaand scopolamine. Polypharmacy overdoses may make the anticholinergic toxidrome less apparent. Avoid haloperidol and droperidol, which may worsen anticholinergic effects.

Learn how your comment data anticholjnergic processed. If you continue using our website, we’ll assume that you are happy to receive all cookies on this website. 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. The symptoms of a sympathomimetic toxidrome include anxietydelusionsdiaphoresishyperreflexiamydriasisparanoiapiloerectionand seizures.


Central inhibition leads to an agitated hyperactive delirium – typically including confusion, restlessness and picking at imaginary objects – which characterises this toxidrome.

It may appear very similar to the anticholinergic toxidrome, but is distinguished by hyperactive bowel sounds and sweating. He created the ‘Critically Anticholinergkc Airway’ course and teaches on numerous courses around the world.

Other toxicological syndromes such as: Consider concentrations for specific agents if available – e. Normal GCS Normal ECG Ensure provision for safe discharge are in place In cases of deliberate ingestion, a risk assessment should indicate that the child or young person is at low risk of further self harm in the discharge setting. Pediatric Anticholinergic Toxidrome Simulation.

Anticholinergic Toxidrome

Diphenhydramine, Doxylamine, Promethazine, Chlorpheniramine, Cyproheptadine. Peripheral inhibition is variable – but the symptoms may include: A toxidrome may indicate a medical emergency requiring treatment at a poison control center. Common symptoms include dizzinessdisorientationnauseavomitingand oscillopsia.

Risk assessment Anticholinergic syndrome may occur following: All patients with intentional ingestions, should be admitted under the adolescent or psychiatric units.

Goldfrank’s Toxicologic Emergencies 6th ed. Bladder scan will reveal the need for a urinary catheter. Complications include bradycardiahypothermiaand tachypnea.