Successful management of olanzapine-induced anticholinergic agitation and delirium with a continuous intravenous infusion of physostigmine in a pediatric patient

Clinical Toxicology

Volumn 51, Issue 3, 2013, Pages 162-166

  Hail, Stacey Lynn ^a   Obafemi, Adebisi ^a   Kleinschmidt, Kurt C ^a  

^a UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

Antidote; CNS Psychological; Complications of poisoning; Olanzapine; Organ tissue specific; Physostigmine

Indexed keywords

BENZODIAZEPINE DERIVATIVE; DEXMEDETOMIDINE; LORAZEPAM; OLANZAPINE; PHYSOSTIGMINE; CHOLINESTERASE INHIBITOR; NEUROLEPTIC AGENT;

ACCIDENT; AGITATION; ANTICHOLINERGIC EFFECT; ARTICLE; ATTENTION DEFICIT DISORDER; CASE REPORT; CHILD; CLINICAL EXAMINATION; CONTINUOUS INFUSION; DELIRIUM; DRUG OVERDOSE; DRUG WITHDRAWAL; ELECTROCARDIOGRAM; HUMAN; INGESTION; MALE; PRESCHOOL CHILD; SEDATION; SINUS TACHYCARDIA; TREMOR; VISUAL HALLUCINATION; AKATHISIA; CHEMICALLY INDUCED DISORDER; DRUG EFFECT; HEART RATE; INTRAVENOUS DRUG ADMINISTRATION;

AKATHISIA, DRUG-INDUCED; ANTIPSYCHOTIC AGENTS; BENZODIAZEPINES; CHILD; CHOLINESTERASE INHIBITORS; DELIRIUM; DRUG OVERDOSE; HEART RATE; HUMANS; INFUSIONS, INTRAVENOUS; MALE; PHYSOSTIGMINE;

MLCS; MLOWN;

EID: 84877015312     PISSN: 15563650     EISSN: 15569519     Source Type: Journal    
DOI: 10.3109/15563650.2013.773006     Document Type: Article

References (14)

1. Burns M, Linden C, Graudins A., Brown R, Fletcher K. A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning. Ann Emerg Med 1999; 35: 4.
2. Smilkstein M. As the pendulum swings: the saga of physostigmine. J Emerg Med 1991; 9: 275-277.
3. Howland M. 2010. Physostigmine salicylate. In: Goldfrank's Toxicologic Emergencies. 9th ed. New York: McGraw Hill Medical.
4. Weizberg M, Mazzola J, Bird S., Brush D, Boyer E. Altered mental status from olanzapine overdose treated with physostigmine. Clin Toxicol 2006; 44: 319-325. (Pubitemid 43982371)
5. Thiesen F, Grabarkiewicz J, Fegbeutel C., Mehler-Wex C, Remschmidt H. Olanzapine overdose in children and adolescents: two case reports and a review of the literature. J Child Adolesc Psychop 2005; 15: 986-995. (Pubitemid 43042990)
6. Bogan R, Zimmerman T, Zilker T., Florian E, Thiermann H. Plasma level of atropine after accidental ingestion of atropa belladonna. Clin Toxicol 2009; 47: 602-604.
7. Rumack B. Anticholinergic poisoning: treatment with physostigmine. Pediatrics 1973; 52: 449-451.
8. Pentel P, Peterson C. Asystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med 1980; 9: 11.
9. Frascogna N. Physostigmine: is there a role for this antidote in pediatric poisonings? Curr Opin Pediatr 2007; 19: 201-205. (Pubitemid 46668074)
10. Stern T. Continuous infusion of physostigmine in anticholinergic delirium: case report. Clin Psychiat 1983; 44: 463-464. (Pubitemid 14214590)
11. Holinger P, Klawans H. Reversal of Tricyclic-overdosage-induced central anticholinergic syndrome by physostigmine. Am J Psychiat 1976; 133: 1085-1087.
12. Rhyee SH, Pedapati EV, Thompson J. Prolonged delirium after quetiapine overdose. Pediatr Emerg Care 2010; 26: 754-756.
13. Tobias J. Dexmedetomidine to control agitation and delirium from toxic ingestions in adolescents. J Pediatr Pharmacol Ther 2010; 15: 43-48.
14. Akingbola O, Singh D. Dexmedetomidine to treat lisdexamfetamine overdose and serotonin toxidrome in a 6-year-old girl. Am J Crit Care 2012; 21: 456-459.