title: [The use of direct and indirect parasympathomimetics in poisonings with tricyclic antidepressive agents].
abstract: The use of cholinesterase inhibitors in poisonings with potentially lethal doses of tricyclic antidepressive drugs seems to be indicated on account of clinical experiences and own experimental investigations on animals. An uncritical use of these substances which have considerable side-effects must be warned of. A mixed intoxication with several drugs effecting on the central nervous system is only a relative indication for the use of indirect parasympathicomimetics of the cholinesterase type. They should be used only then, when the picture of poisoning is unequivocally determined by the thymoleptics. When cholinesterase inhibitors are used the physostigmine salicylate should be preferred, since at present it is sufficiently accessible to the central nervous system and with the slightest peripheral effects as the only representative of this group of substances, above all with regard to the gastrointestinal motility. Later investigations shall show, whether also other groups of substances which develop an antagonistic effect to the tricyclic antidepressive drugs may be of use in the treatment of the acute poisoning.
mesh_terms: D000639:Amitriptyline / Q000506:poisoning; D000818:Animals; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001115:Arecoline / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003128:Coma / Q000188:drug therapy; D003986:Dibenzocycloheptenes / Q000506:poisoning; D007099:Imipramine / Q000506:poisoning; D010261:Paraoxon / Q000627:therapeutic use; D010830:Physostigmine / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D051381:Rats
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002800:Cholinesterase Inhibitors; D003986:Dibenzocycloheptenes; D000639:Amitriptyline; D001115:Arecoline; D010830:Physostigmine; D011729:Pyridostigmine Bromide; D007099:Imipramine; D010261:Paraoxon
vernacular_title: Die Anwendung direkter und indirekter Parasympathikomimetika bei Intoxikationen mit trizyklischen Antidepressiva.