title: Accidental acute clidinium toxicity.
abstract: Clidinium bromide (N-methyl-quinuclidinyl-benzylate) is a rarely used antimuscarinic drug that is marketed in combination with chlordiazepoxide as an antispasmodic for use in irritable bowel syndrome. A case is reported of an accidental staggered overdose of clidinium bromide 50 mg in a patient using illicit chlordiazepoxide. The presenting features were mildly dilated pupils and palpitation secondary to sinus tachycardia that persisted for 11 h after the time of first ingestion. Emergency physicians should be aware of the potential for antimuscarinic toxicity in patients using illicit chlordiazepoxide.
authors.affiliation: Emergency Department, John Radcliffe Hospital, Headley Way, Oxford, UK. serichardson@doctors.org.uk
authors.forename: S E
authors.initials: SE
authors.lastname: Richardson
authors.forename: K
authors.initials: K
authors.lastname: Edwards
mesh_terms: D000208:Acute Disease; D000328:Adult; D002707:Chlordiazepoxide / Q000506:poisoning*; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D008297:Male; D015878:Mydriasis / Q000139:chemically induced; D010276:Parasympatholytics / Q000506:poisoning*; D011813:Quinuclidinyl Benzilate / Q000031:analogs & derivatives* / Q000506:poisoning; D013616:Tachycardia, Sinus / Q000139:chemically induced
chemical_list: D013287:Illicit Drugs; D010276:Parasympatholytics; D011813:Quinuclidinyl Benzilate; D002707:Chlordiazepoxide; C054940:clidinium