title: Treatment of acute anticholinergic poisoning with physostigmine.
abstract: Five cases of acute anticholinergic poisoning presenting to an inner-city emergency department (ED) are discussed. All five patients presented with classic signs and symptoms of anticholinergic toxicity, which included tachycardia, hot, dry and flushed skin, markedly dilated and fixed pupils, and pronounced delirium. The patients were violently agitated, and physical restraint was required. Initial treatment with benzodiazepines did not diminish their combative behavior. Treatment with intravenous physostigmine salicylate resulted in a decrease in agitation within 15 to 20 minutes of therapy. No untoward effects occurred as a result of treatment with physostigmine.
authors.affiliation: Department of Emergency Medicine, Allegheny, University Hospital-Hahnemann Division, Philadelphia, PA 19102, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Beaver
authors.forename: T J
authors.initials: TJ
authors.lastname: Gavin
mesh_terms: D000328:Adult; D000931:Antidotes / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000506:poisoning*; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D006339:Heart Rate / Q000187:drug effects; D006786:Hospitals, Urban; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D015143:Philadelphia; D010830:Physostigmine / Q000627:therapeutic use*; D012119:Respiration / Q000187:drug effects
chemical_list: D000931:Antidotes; D018680:Cholinergic Antagonists; D010830:Physostigmine