Treatment of Adolescent Antimuscarinic (Anticholinergic) Toxidrome
Status:
Completed
Trial end date:
2020-08-31
Target enrollment:
Participant gender:
Summary
Overdose of xenobiotics (antihistamines, antipsychotics, or Jimson Weed) with resulting
antimuscarinic toxidrome is a common scenario in medical toxicology. The result of antagonism
of muscarinic receptors is a constellation of signs and symptoms (toxidrome): mydriasis,
decreased sweat, decreased bowel sounds, agitation, delirium, hallucinations, urinary
retention, tachycardia, flushed skin and seizures. Two treatment options are physostigmine or
benzodiazepines.
Although the antimuscarinic toxidrome occurs commonly, physostigmine has been used sparingly
despite evidence of safety and efficacy. To demonstrate the utility and safety of
physostigmine, the investigators propose a randomized clinical trial of physostigmine
compared to benzodiazepine for antimuscarinic toxicity.