title: [Case report of atropine poisoning, after accidental ingestion of 500mg atropine sulfate].
abstract: A case report of atropine intoxication, after the accidental ingestion of 500mg atropine sulfate is presented. The patient was a 58 year old male. Atropine sulfate 0.5mg p.o. was prescribed but inadvertently 500mg was dispensed by the pharmacy. Within 1 hour of ingestion, the patient became unconscious and was admitted to Saint Luke's International Hospital. Unresponsive to verbal and tactile stimuli with a significant decrease in response to painful stimuli, respiratory suppression, and mydriasis were evident. The serum concentration of atropine at the time of admission (4 hour after ingestion) was 244 ng/mL. He was treated in our ICU and placed under sedation utilizing in a Propofol and Fentanyl intravenously. Ventilator control, ECG monitoring and intravenous fluid support was provided. Three days after admission, the patient's level of consciousness improved. After 5 days, he was transferred to a general ward. Upon discharge, only mild diplopia remained as a sequela of the intoxication. The patient was followed in the outpatient department and his health returned to pre-ingestion level. Clinically, the diagnosis of atropine intoxication is difficult to make. If information regarding atropine ingestion is not readily available, adequate respiratory support, circulatory monitoring and proper symptomatic treatment are necessary to ensure recovery.
authors.affiliation: St. Luke's International Hospital, Department of Emergency and Critical Care Medicine.
authors.forename: Norio
authors.initials: N
authors.lastname: Otani
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Shiino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mii
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Aoki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishimatsu
mesh_terms: D001285:Atropine / Q000493:pharmacokinetics / Q000506:poisoning*; D002606:Charcoal / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D062787:Drug Overdose; D005751:Gastric Lavage; D006801:Humans; D008297:Male; D008508:Medication Errors; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D002606:Charcoal; D009388:Neostigmine; D001285:Atropine