title: Intoxication with a tropenol ester.
abstract: BACKGROUND
  While the effects of medicinal products are investigated in depth before approval, often very little is known about the intermediates occurring during synthesis. The pharmacological properties of these intermediates can differ substantially from those of the end product.
  
  
  OBJECTIVE
  To describe a work accident involving intoxication with such an intermediate, tropenol ester.
  
  
  METHODS
  A healthy 40-year-old chemical-technical operative erroneously used a scrubbing brush that had just been used to clear up tropenol ester, contaminating his work clothes. Presumably, contact was made with his skin when removing his work clothes later. Shortly thereafter, he developed signs of anticholinergic intoxication with mydriasis, dry mouth, abnormal coordination and later sleepiness and seizures. The patient received intensive medical treatment. Two weeks later, the anticholinergic symptoms had subsided. Qualitative analysis of a urine sample showed traces of tropenol ester. The substance is a muscarinic acetylcholine receptor antagonist.
  
  
  CONCLUSIONS
  The clinical symptoms and biomonitoring suggest that intoxication with tropenol ester had occurred, which, as a tertiary amine, readily passes through the blood-brain barrier. The protracted course suggests high affinity for the receptor. Appropriate safety precautions must be taken when handling research substances and intermediates of unknown toxicity.
authors.affiliation: Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Obere Zahlbacher Straβe 67, D-55131 Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Muttray
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.forename: S
authors.initials: S
authors.lastname: Letzel
mesh_terms: D000328:Adult; D001259:Ataxia / Q000139:chemically induced; D018680:Cholinergic Antagonists / Q000506:poisoning*; D004952:Esters; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000506:poisoning*; D015878:Mydriasis / Q000139:chemically induced; D016273:Occupational Exposure / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced
chemical_list: D018680:Cholinergic Antagonists; D004952:Esters; D018727:Muscarinic Antagonists