title: Case of the month: rivastigmine (Exelon) toxicity with evidence of respiratory depression.
abstract: Rivastigmine, which has been approved by the US Food and Drugs Administration for the treatment of Alzheimer's disease, is a non-competitive reversible inhibitor of acetylcholinesterase. We present a case of rivastigmine toxicity at a dose of 90 mg, with evidence of respiratory depression. To our knowledge, this case report provides evidence of the highest rivastigmine ingestion recorded (90 mg) that caused respiratory depression but requiring only supportive intervention without the need for ralidoxime. Emergency physicians should strongly consider cholinesterase inhibitor (rivastigmine, galantamine, and tacrine) ingestion in patients who present with short and temporary organophosphate-like toxidromes.
authors.affiliation: Department of Emergency Medicine, Akay Medical Center, Ankara, Turkey. ssener@tr.net
authors.forename: S
authors.initials: S
authors.lastname: Sener
authors.forename: M
authors.initials: M
authors.lastname: Ozsarac
mesh_terms: D000328:Adult; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000506:poisoning*; D048448:Phenylcarbamates / Q000506:poisoning*; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D000068836:Rivastigmine; D013406:Suicide, Attempted
chemical_list: D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine