Anticholinergic delirium caused by topical homatropine ophthalmologic solution: confirmation by anticholinergic radioreceptor assay in two cases.
The authors report two patients with prolonged metabolic delirium presumably initiated by systemic absorption of homatropine from a topical ophthalmologic solution. Anticholinergic toxicity was confirmed by muscarinic radioreceptor assay in both cases and by quantitative EEG in one case.
Tune
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Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Bylsma
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Hilt
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D000368:Aged; D003693:Delirium / Q000097:blood / Q000139:chemically induced*; D005128:Eye Diseases / Q000097:blood / Q000188:drug therapy*; D005901:Glaucoma / Q000097:blood / Q000188:drug therapy; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions; D010276:Parasympatholytics / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D011813:Quinuclidinyl Benzilate / Q000493:pharmacokinetics; D011869:Radioligand Assay; D011976:Receptors, Muscarinic / Q000187:drug effects* / Q000502:physiology; D014326:Tropanes / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
D009883:Ophthalmic Solutions; D010276:Parasympatholytics; D011976:Receptors, Muscarinic; D014326:Tropanes; D011813:Quinuclidinyl Benzilate; C100236:homatropine