Central anti-cholinergic syndrome induced by single therapeutic dose of atropine.
A 55 years old male patient, who is planned for bronchoscopy developed central anti-cholinergic syndrome due to therapeutic dose of atropine. Withdrawal of atropine has improved the symptoms. Thereafter, instillation of atropine as eye drops leads to reappearance of symptoms. The reaction was definite according to Naranjo's algorithm. It was severe and definitely preventable according to Modified Hartwig and Siegel's scale and Modified Schumock and Thornton scale respectively. Central anti-cholinergic syndrome may be due to variation in the genetic susceptibility (Idiosyncrasy) to atropine. Idiosyncratic reaction on administration of atropine as a pre-anesthetic medication or eye drops should be kept in mind while prescribing.
Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar-364001, Gujarat, India.
Ashwin
A
Panchasara
Divyesh
D
Mandavia
Ashish P
AP
Anovadiya
C B
CB
Tripathi
D001285:Atropine / Q000008:administration & dosage / Q000009:adverse effects*; D001999:Bronchoscopy / Q000379:methods*; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D013577:Syndrome
D018680:Cholinergic Antagonists; D018727:Muscarinic Antagonists; D001285:Atropine