{"pk":19260,"title":"Massive Atropine Eye Drop Ingestion Treated with High-Dose Physostigmine to Avoid Intubation","subtitle":null,"abstract":"Case: A 34-year-old male presented after ingesting 150 mg of atropine. He had altered mental status, sinus tachycardia, dry mucosa, flushed skin, and hyperthermia. Sequential doses of physostigmine, totaling 14 mg, were successful in reversing antimuscarinic toxicity and prevented the need to perform airway control with endotracheal intubation. At completion of treatment, heart rate and mental status had improved, and intubation was never performed.\nDiscussion: Atropine causes anticholinergic toxicity; physostigmine reverses this by inhibiting acetylcholinesterase. Atropine eye drop ingestions are rare. The 14 mg of physostigmine administered is much higher than typical dosing. It is likely the physostigmine prevented intubation. Atropine eye drops can be dangerous, and physostigmine should be considered in treatment. [West J Emerg Med. 2012;13(1):77–79.]","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Atropine"},{"word":"anticholinergic"},{"word":"antimuscarinic"},{"word":"Physostigmine"},{"word":"intubation"},{"word":"Diagnosis"},{"word":"Emergency Medicine"},{"word":"Medicine"},{"word":"Therapeutics"}],"section":"Toxicology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3064x58m","frozenauthors":[{"first_name":"Samuel","middle_name":"J","last_name":"Stellpflug","name_suffix":"","institution":"Regions Hospital, Department of Emergency Medicine, Toxicology Education and\nClinical Service, St Paul, Minnesota","department":"None"},{"first_name":"Jon","middle_name":"B","last_name":"Cole","name_suffix":"","institution":"Regions Hospital, Department of Emergency Medicine, Toxicology Education and\nClinical Service, St Paul, Minnesota; Hennepin Regional Poison Center, Minneapolis, Minnesota","department":"None"},{"first_name":"Brian","middle_name":"A","last_name":"Isaacson","name_suffix":"","institution":"Fairview Ridges Medical Center, Department of Emergency Medicine, Burnsville,\nMinnesota","department":"None"},{"first_name":"Christian","middle_name":"P","last_name":"Lintner","name_suffix":"","institution":"Hennepin Regional Poison Center, Minneapolis, Minnesota","department":"None"},{"first_name":"Elisabeth","middle_name":"F","last_name":"Bilden","name_suffix":"","institution":"Hennepin Regional Poison Center, Minneapolis, Minnesota","department":"None"}],"date_submitted":"2011-05-31T20:46:28Z","date_accepted":"2011-05-31T20:46:28Z","date_published":"2012-02-24T18:39:56Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/19260/galley/9533/download/"}]}