Template:Anticholinergic Toxicity Treatement: Difference between revisions

Revision as of 04:36, 3 February 2016

GI decon
- Activated Charcoal may be effective even >1hr after ingestion (decreased GI motility)
Sedation
- Decreases the risk of hyperthermia, rhabdo, traumatic injuries
- Benzos are agents of choice especially increase seizure threshold
Conduction abnormalities (QRS prolongation)
- Sodium Bicarbonate
  - Should be given at 2 mEq/kg
  - Typically 2-3 amps of bicarb
  - Begin continuous NaCO3 infusions if bolus effective
  - Solution preparation = 1L D5W mixed with 3 ampules NaHCO3
  - Run NaHCO3 solutions at 250 mL/hr
Cholinesterase inhibition
- Indicated for severe agitation or delirium (esp if unresponsive to benzos)
- Avoid when cardiac conduction abnormalities are present
- Physostigmine
  - Dosing: 0.5-2mg IV over 5min
  - Onset of action: 15-20min
  - Side effects: bradycardia, dysrhythmias, cholinergic excess
  - always have atropine at the bedside for bradycardia or cholinergic excess

@@ Line 5: / Line 5: @@
 #*Decreases the risk of [[hyperthermia]], [[rhabdo]], traumatic injuries
 #*[[Benzos]] are agents of choice especially increase seizure threshold
+#Conduction abnormalities (QRS prolongation)
+#*Sodium Bicarbonate
+#**Should be given at 2 mEq/kg
+#**Typically 2-3 amps of bicarb
+#**Begin continuous NaCO3 infusions if bolus effective
+#**Solution preparation = 1L D5W mixed with 3 ampules NaHCO3
+#**Run NaHCO3 solutions at 250 mL/hr
 #Cholinesterase inhibition
 #*Indicated for severe agitation or delirium (esp if unresponsive to [[benzos]])