Anticholinergic Toxicity Questions & Answers

Updated: Dec 17, 2019
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: David Vearrier, MD, MPH  more...
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Questions & Answers

Overview

What is anticholinergic syndrome (ACS)?

What are the signs and symptoms of anticholinergic syndrome (ACS)?

How is anticholinergic overdose diagnosed?

What is the initial treatment for anticholinergic toxicity?

How is anticholinergic toxicity managed?

What is the pathophysiology of anticholinergic toxicity?

What causes anticholinergic syndrome (ACS)?

What is the incidence of anticholinergic drug exposure in the US?

Presentation

What is the focus of history in suspected anticholinergic toxicity?

What is the role of anticholinergic toxicity in cognitive impairment?

What are common signs and symptoms of anticholinergic toxicity?

What are less common symptoms of anticholinergic toxicity?

Which drug classes have anticholinergic properties?

Which antihistamines have anticholinergic properties?

Which antipsychotics have anticholinergic properties?

Which antispasmodics have anticholinergic properties?

Which cyclic antidepressants have anticholinergic properties?

Which mydriatics have anticholinergic properties?

Which miscellaneous drugs have anticholinergic properties?

Which plants have anticholinergic properties?

Which mushrooms have anticholinergic properties?

DDX

What are the differential diagnoses for Anticholinergic Toxicity?

Workup

What is the role of lab studies in the diagnosis of anticholinergic toxicity?

What is the role of imaging studies in the diagnosis of anticholinergic toxicity?

What is the role of electrocardiogram (ECG) in the diagnosis of anticholinergic toxicity?

What is the role of lumbar puncture (LP) in the diagnosis of anticholinergic toxicity?

Treatment

What is included in prehospital care for anticholinergic toxicity?

What is included in the initial emergency department (ED) response to suspected anticholinergic toxicity?

What is included in emergency department (ED) care for anticholinergic toxicity following initial stabilization?

Which treatments are ineffective for anticholinergic toxicity?

What supportive care may be needed in the treatment of anticholinergic toxicity?

How should seizures and hallucinations be managed in anticholinergic toxicity?

What is the antidote for anticholinergic toxicity and how does it work?

What are common side effects of physostigmine salicylate for anticholinergic toxicity?

What is the role of benzodiazepines in the treatment of anticholinergic toxicity?

When is physostigmine contraindicated in the treatment of anticholinergic toxicity?

Which specialist consultations may be beneficial in the treatment of anticholinergic toxicity?

Medications

Which medications are used in the treatment of anticholinergic toxicity?

Which medications in the drug class Cholinergic agents are used in the treatment of Anticholinergic Toxicity?

Which medications in the drug class Cardiovascular agents are used in the treatment of Anticholinergic Toxicity?

Which medications in the drug class Benzodiazepines and other sedatives are used in the treatment of Anticholinergic Toxicity?

Which medications in the drug class GI decontaminant are used in the treatment of Anticholinergic Toxicity?