title: Full recovery from a potentially lethal dose of orphenadrine ingestion using conservative treatment: a case report.
abstract: Intoxication by orphenadrine is uncommon. The clinical features consist of both central and peripheral anticholinergic effects. Ingestion of 2 to 3 g orphenadrine in an adult has been associated with fatality. A 46-year-old female was brought to our emergency department 1.5 hours after ingesting 40 tablets of 100 mg orphenadrine. She became stuporous 3 hours post-ingestion and developed generalized convulsions 1 hour later. Fifty-five hours post-ingestion, she had recovered and was found to have anterior shoulder dislocation. In addition, severe rhabdomyolysis and persistent nausea were observed. All of the above-noted toxic effects resolved with conservative treatment. Although orphenadrine intoxication can cause convulsions and hemodynamic instability, there is no available antidote and treatment remains supportive.
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yan-Chiao
authors.initials: YC
authors.lastname: Mao
authors.forename: Dong-Zong
authors.initials: DZ
authors.lastname: Hung
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Yang
authors.forename: Jiaan-Der
authors.initials: JD
authors.lastname: Wang
mesh_terms: D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000506:poisoning*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009966:Orphenadrine / Q000506:poisoning*; D011041:Poisoning / Q000175:diagnosis / Q000628:therapy; D011859:Radiography; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D018680:Cholinergic Antagonists; D002606:Charcoal; D009966:Orphenadrine