Ostermayer: Created page with "Template:Anticholinergic Toxicity Treatement"

2026-01-23T09:06:47Z

Created page with "Template:Anticholinergic Toxicity Treatement"

← Older revision		Revision as of 09:06, 23 January 2026
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	===Inhibición de la colinesterasa===		===Inhibición de la colinesterasa===

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~		*Indicado para agitación o delirio severo (especialmente si no responde a [[Special:MyLanguage/benzos\|benzodiazepinas]])
	*~~Indicated for severe agitation or delirium~~ (~~esp if unresponsive to~~ [[Special:MyLanguage/benzos\|~~benzos~~]])		*Contraindicado en QRS>100 o signos de bloqueo de Na (R' en aVR) y en glaucoma de ángulo estrecho
	*~~Contraindicated in~~ QRS>100 or Na ~~blockade signs~~ (R' in aVR) ~~and in narrow angle~~ glaucoma		*Relativamente contraindicado en asma o íleo
	*~~Relatively contraindicated in asthma or ileus~~		*[[Special:MyLanguage/Physostigmine\|Fisostigmina]] - considere fuertemente consultar con control de intoxicaciones antes de administrar
	*[[Special:MyLanguage/Physostigmine\|~~Physostigmine~~]] - ~~strongly consider poison~~ control ~~consult before giving~~		**Cruza la barrera hematoencefálica, puede usarse para ayudar a establecer el diagnóstico
	**~~Crosses blood brain barrier~~, ~~can be used to help make dx~~		**Dosis: 0.5mg-1mg IV durante 5min (repetir dosis hasta 2mg en la primera hora)<ref>Rosenbaum C and Bird SB. Timing and frequency for physostigmine redosing for antimuscarininc toxicity. J Med Toxicol. 2010;6:386-92.</ref>
	**~~Dosing~~: 0.5mg-1mg IV ~~over~~ 5min (~~repeat dosing up to~~ 2mg ~~in first hour~~)<ref>Rosenbaum C and Bird SB. Timing and frequency for physostigmine redosing for antimuscarininc toxicity. J Med Toxicol. 2010;6:386-92.</ref>		**Inicio de acción: 5-10min
	**~~Onset of action~~: 5-10min		**Si hay respuesta parcial, repetir x3
	**~~If partial response~~, ~~repeat~~ x3		**Si se necesitan 3 o más administraciones en un período de 6 horas, iniciar infusión IV (bolo 1-2 mg seguido de 1 mg/hora)
	**If 3 ~~or more administrations are needed over a~~ 6~~-hour period~~, ~~start~~ IV ~~infusion~~ (~~bolus~~ 1-2 mg ~~followed by~~ 1 mg/~~hour~~)		**Detener la infusión cada 12 horas para determinar la resolución del toxidromo
	**~~Stop infusion every~~ 12 ~~hours to determine resolution of the toxidrome~~		**Efectos secundarios: bradicardia, disritmias, exceso colinérgico<ref>Pentel P and Peterson CD. Aystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med. 1980 Nov;9(11):588-90.</ref>
	**~~Side effects~~: ~~bradycardia~~, ~~dysrhythmias~~, ~~cholinergic excess~~<ref>Pentel P and Peterson CD. Aystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med. 1980 Nov;9(11):588-90.</ref>		**Siempre tener [[Special:MyLanguage/atropine\|atropina]] al lado de la cama para bradicardia o exceso colinérgico</ref><ref>Nguyen TT, et al. Adverse events from physostigmine: an observational study. Am J Emerg Med. 2018;36:141-2.</ref>
	**~~Always have~~ [[Special:MyLanguage/atropine\|~~atropine~~]] ~~at the bedside for bradycardia or cholinergic excess~~</ref><ref>Nguyen TT, et al. Adverse events from physostigmine: an observational study. Am J Emerg Med. 2018;36:141-2.</ref>		**'''Contraindicado''' en [[Special:MyLanguage/TCA toxicity\|toxicidad por TCA]] (asociado con paro cardíaco) y en presencia de bradicardia o bloqueo AV
	**'''~~Contraindicated~~''' in [[Special:MyLanguage/TCA toxicity\|TCA ~~toxicity~~]] (~~associated with cardiac arrest~~) ~~and in the presence of bradycardia or~~ AV ~~block~~
	~~</div>~~

	~~<div lang~~=~~"en" dir~~=~~"ltr" class~~=~~"mw-content-ltr">~~		===Otras terapias===
	===~~Other therapies===~~
	~~</div>~~

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~		*[[Special:MyLanguage/Sodium bicarbonate\|Bicarbonato de sodio]] para anomalías de conducción (prolongación del QRS)
	*[[Special:MyLanguage/Sodium bicarbonate\|~~Sodium bicarbonate~~]] ~~for conduction abnormalities~~ (QRS ~~prolongation~~)		**Bolo de 2 mEq/kg (típicamente 2-3 ampolletas de bicarbonato)
	**2 mEq/kg ~~bolus~~ (~~typically~~ 2-3 ~~amps of bicarb~~)		**Iniciar infusión continua de NaCO3 a 250mL/hr si el bolo es efectivo
	**~~Begin continuous~~ NaCO3 ~~infusion at~~ 250mL/hr ~~if bolus effective~~		**Preparación de la solución = 1L de D5W mezclado con 3 ampolletas de NaHCO3
	**~~Solution preparation~~ = 1L D5W ~~mixed with~~ 3 ~~ampules~~ NaHCO3
	~~</div>~~

Ostermayer: Created page with "==Tratamiento=="

2026-01-23T09:04:31Z

Created page with "==Tratamiento=="

New page

<noinclude><languages/></noinclude>

==Tratamiento==

*Considerar descontaminación GI con [[Special:MyLanguage/Activated Charcoal|Carbón Activado]] si el paciente presenta <2 horas después de la ingestión y permanece cooperativo

===Sedación===

*Disminuye el riesgo de [[Special:MyLanguage/hyperthermia|hipertermia]], [[Special:MyLanguage/rhabdo|rabdomiólisis]], lesiones traumáticas
*[[Special:MyLanguage/Benzos|Benzodiazepinas]] son los agentes de elección especialmente aumentan el umbral convulsivo<ref>Burns MJ, et al. A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning. Ann Emerg Med. 2000:35(4):374-381.</ref>
**Repetir bólus cada 5-15 minutos según sea necesario para detener las convulsiones y proporcionar sedación adecuada
**Objetivo: duración del QRS < 110 mseg

===Inhibición de la colinesterasa===

<div lang="en" dir="ltr" class="mw-content-ltr">
*Indicated for severe agitation or delirium (esp if unresponsive to [[Special:MyLanguage/benzos|benzos]])
*Contraindicated in QRS>100 or Na blockade signs (R' in aVR) and in narrow angle glaucoma
*Relatively contraindicated in asthma or ileus
*[[Special:MyLanguage/Physostigmine|Physostigmine]] - strongly consider poison control consult before giving
**Crosses blood brain barrier, can be used to help make dx
**Dosing: 0.5mg-1mg IV over 5min (repeat dosing up to 2mg in first hour)<ref>Rosenbaum C and Bird SB. Timing and frequency for physostigmine redosing for antimuscarininc toxicity. J Med Toxicol. 2010;6:386-92.</ref>
**Onset of action: 5-10min
**If partial response, repeat x3
**If 3 or more administrations are needed over a 6-hour period, start IV infusion (bolus 1-2 mg followed by 1 mg/hour)
**Stop infusion every 12 hours to determine resolution of the toxidrome
**Side effects: bradycardia, dysrhythmias, cholinergic excess<ref>Pentel P and Peterson CD. Aystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med. 1980 Nov;9(11):588-90.</ref>
**Always have [[Special:MyLanguage/atropine|atropine]] at the bedside for bradycardia or cholinergic excess</ref><ref>Nguyen TT, et al. Adverse events from physostigmine: an observational study. Am J Emerg Med. 2018;36:141-2.</ref>
**'''Contraindicated''' in [[Special:MyLanguage/TCA toxicity|TCA toxicity]] (associated with cardiac arrest) and in the presence of bradycardia or AV block
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
===Other therapies===
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
*[[Special:MyLanguage/Sodium bicarbonate|Sodium bicarbonate]] for conduction abnormalities (QRS prolongation)
**2 mEq/kg bolus (typically 2-3 amps of bicarb)
**Begin continuous NaCO3 infusion at 250mL/hr if bolus effective
**Solution preparation = 1L D5W mixed with 3 ampules NaHCO3
</div>

Template:Anticholinergic Toxicity Treatement/es - Revision history

Ostermayer: Created page with "Template:Anticholinergic Toxicity Treatement"

Ostermayer: Created page with "==Tratamiento=="