title: [A case of acute cholinergic adverse effects induced by donepezil overdose: a follow-up of clinical course and plasma concentration of donepezil].
abstract: A 79-year-old woman with Alzheimer's disease was admitted due to acute cholinergic symptoms induced by overdose (45 mg) of donepezil (DPZ). Physical examination showed bradycardia, sinus arrhythmia, vomiting and respiratory insufficiency. She was treated with atropine intravenously and her cholinergic symptoms subsided in the next evening. After 5 days she was discharged from the hospital and DPZ was withholded for about 4 weeks. The plasma concentration of DPZ was 54.6 ng/ml on admission and gradually decreased to the normal limits in about 90 hours. The calculative half-life of DPZ was about 55 hours. Since the half-life of DPZ is long and differs between individuals, hospitalization and treatment with atropine is recommended for cholinergic side effects induced by overdose of DPZ. It is important to prevent dosing errors in cooperation with medical providers, patients and families.
authors.affiliation: Department of Neurology, Tottori University School of Medicine.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Yano
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fukuhara
authors.forename: Kenji
authors.initials: K
authors.lastname: Wada
authors.forename: Hisanori
authors.initials: H
authors.lastname: Kowa
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D001146:Arrhythmia, Sinus / Q000139:chemically induced; D001919:Bradycardia / Q000139:chemically induced; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000097:blood*; D000077265:Donepezil; D062787:Drug Overdose; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007189:Indans / Q000009:adverse effects* / Q000097:blood*; D010880:Piperidines / Q000009:adverse effects* / Q000097:blood*; D014839:Vomiting / Q000139:chemically induced
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil