ÖZET
Antikolinerjikler, bir nörotransmitter olan asetilkolinin etkinliğini antagonize eden maddelerdir. Antikolinerjik sendrom (AS), özkıyım amaçlı aşırı doz alımlarında, kaza ile alımlarda, ilaç 5 uyumsuzluklarında ve birden fazla ilaç kullanan kişilerde meydana gelmektedir. Yazımızda, acil servise deliryum tablosu ile başvurup antikolinerjik toksidromun diğer belirtileri ile AS tanısı konularak fizostigmin tedavisi uygulanan iki olgu sunulmaktadır.
References
1
O’Donnell KA, Osterhoudt KC, Burns MM, Calello DP, Henreting FM. Toxicologic Emergencies. In: Shaw KN, Bachur RG (Ed.):Fleisher & Ludwig’s textbook of pediatric emergency medicine. Baltimore, Lippincott Williams & Wilkins; 2015;7:1061-111.
2
Demirhan A, Tekelioğlu ÜY, Yıldız İ, Korkmaz T, Bilgi M, et al. Anticholinergic Toxic Syndrome Caused by Atropa Belladonna Fruit (Deadly Nightshade): A Case Report. Turk J Anaesthesiol Reanim. 2013;41:226-8.
3
Sharma AN, Hexdall AH, Chang EK, Nelson LS, Hoffman RS. Diphenhydramine-induced wide complex dysrhythmia responds to treatment with sodium bicarbonate. Am J Emerg Med. 2003;21:212-5.
4
Katsanoulas K, Papaioannou A, Fraidakis O, Michaloudis D. Undiagnosed central anticholinergic syndrome may lead to dangerous complications. Eur J Anaesthesiol. 1999;16:803-9.
5
Brown JH, Laiken N. Chapter 9Muscarinic Receptor agonistsand antagonists. In: Brunton LL, Bruce AC, Bjorn CK (Eds.): Goodman &Gilman the pharmacologic basis of therapeutics. New York: McGraw-Hill, 2011;11:219-35.
6
Graziano S, Orsolini L, Rotolo MC, Tittarelli R, Schifano F, Pichini S. Herbal Highs: Review on Psychoactive Effects and Neuropharmacology. Curr Neuropharmacol. 2017;15:750-61.
7
Krenzelok EP, Leikin JB. Approach to the poisoned patient. Dis Mon. 1996;42:509-607.
8
Forrester MB. Jimsonweed (Datura stramonium) exposures in Texas, 1998-2004. J Toxicol Environ Health A. 2006;69:1757-62.
9
Kose R, Sahin OO, Abay E. A case of delirium due to datura stramonium intoxication. Anatol J Psychiatr. 2008;9:54-7.
10
Bayraktar E. Deliryum, demans, amnestik ve diğer kognitif bozukluklar. İçinde: Güleç C, Köroğlu E (ed.ler). Psikiyatri Temel Kitabı. 1. Baskı. Ankara, Hekimler Yayın Birliği. 1996;221-56.
11
Vanderhoff BT, Mosser KH. Jimson weed toxicity: Management of anticholinergic plant ingestion. Am Fam Physician. 1992;46:526-30.
12
Wolf LR. Anticholinergic toxicity. In: Tintinalli JE, Kellen GD, Stapezynski JS (Eds.). Emergency Medicine: A comprehensive study guide. 5th ed. New York: McGraw-Hill; 2000:1182-5.
13
Rosenbaum C, Bird SB. Timing and frequency of physostigmine redosing for antimuscarinic toxicity. J Med Toxicol. 2010;6:386-92.
14
Thornton SL, Farnaes L, Minns A. Prolonged antimuscarinic delirium in a child due to benztropine exposure treated with multiple doses of physostigmine. Pediatr Emerg Care. 2016;32:243-5.
15
Bryant S, Singer J. Management of toxic exposure in children. Emerg Med Clin North Am. 2003;21:101-19.
16
Savitt DL, Roberts JR, Siegel EG. Anisocoria From Jimsonweed. JAMA. 1986;255:1439-40.
