Anticholinergic Syndrome

Adverse drug effects associated with CHOLINERGIC ANTAGONISTS. Clinical features include TACHYCARDIA; HYPERTHERMIA; MYDRIASIS, dry skin and dry mucous membranes, decreased bowel sounds and urinary retention in peripheral anticholinergic syndrome; and HALLUCINATIONS; PSYCHOSES; SEIZURES; and COMA in central anticholinergic syndrome.

Also Known As:

Central Anticholinergic Syndrome; Peripheral Anticholinergic Syndrome; Anticholinergic Syndrome, Central; Anticholinergic Syndrome, Peripheral; Anticholinergic Syndromes; Anticholinergic Syndromes, Central; Anticholinergic Syndromes, Peripheral; Central Anticholinergic Syndromes; Peripheral Anticholinergic Syndromes; Syndrome, Anticholinergic; Syndrome, Central Anticholinergic; Syndrome, Peripheral Anticholinergic; Syndromes, Anticholinergic; Syndromes, Central Anticholinergic; Syndromes, Peripheral Anticholinergic

Networked: 150 relevant articles (7 outcomes, 5 trials/studies)

Relationship Network

Disease Context: Research Results

Chemically-Induced Disorders: 2
- Drug-Related Side Effects and Adverse Reactions: 13596
  - Anticholinergic Syndrome: 150

Related Diseases

1.	Delirium
2.	Confusion (Bewilderment)
3.	Respiratory Insufficiency (Respiratory Failure)
4.	Hallucinations (Hallucination)
5.	Mydriasis

Experts

1.	Gonzalez, Lola: 1 article (05/2022)
2.	Laribi, Saïd: 1 article (05/2022)
3.	Rousseau, Geoffroy: 1 article (05/2022)
4.	Soletchnik, Mickael: 1 article (05/2022)
5.	Eiglmeier, Hans: 1 article (02/2022)
6.	Eyer, Florian: 1 article (02/2022)
7.	Romanek, Katrin: 1 article (02/2022)
8.	Schmoll, Sabrina: 1 article (02/2022)
9.	Zorn, Gabriel: 1 article (02/2022)
10.	Cortese, Teena: 1 article (01/2022)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Anticholinergic Syndrome:

1.	PhysostigmineIBA 07/01/1997 - "It is recommended that 1 mg of intravenous physostigmine is a safe and effective treatment for central anticholinergic syndrome, and that a supply of this important drug must be kept readily available in the recovery area of the operating theatre department." 02/16/2021 - "Our approach was to refrain from detoxication to minimize complications and to treat early with physostigmine because of anticholinergic syndrome to minimize its impact and to avoid artificial ventilation due do vigilance impairment." 03/01/2015 - "Response: physostigmine may not be the only option for treating anticholinergic syndrome." 03/01/2004 - "A rapid improvement of mental status with physostigmine confirmed the diagnosis of anticholinergic syndrome. " 08/01/2003 - "However, because of the low incidence of a classical central anticholinergic syndrome, routine physostigmine is only indicated when agitation is diagnosed."
2.	Atropine FDA LinkGeneric 02/01/2016 - "Central anticholinergic syndrome vs. idiosyncratic reaction triggered by a small IV dose of atropine." 11/05/2015 - "Unintentionally, this was equivalent to a very large (15 mg) dose of atropine and she presented in an acute anticholinergic syndrome (confused, tachycardic and hypertensive) to our accident and emergency department. " 10/10/1995 - "We report on a patient who developed typical signs of central and peripheral anticholinergic syndrome within a few hours after intake of atropine through her nose. " 01/01/1991 - "We report the occurrence of a central anticholinergic syndrome in a patient treated with aerosolized atropine." 04/01/1982 - "Higher doses may be associated with an increase in side-effects with more pronounced dryness of the mouth and tachycardia and, with atropine, a greater likelihood of the production of the "central anticholinergic syndrome"."
3.	Scopolamine (Hyoscine)FDA Link 12/01/2007 - "Neurological status rapidly and completely improved after removal of transdermal scopolamine suggesting a central anticholinergic syndrome." 11/15/2022 - "Central anticholinergic syndrome from hyoscine hydrobromide in an unresponsive patient." 10/01/2009 - "We describe a patient who presented with symptoms of anticholinergic syndrome secondary to an unintentional overdose of scopolamine. " 10/01/2009 - "Anticholinergic syndrome following an unintentional overdose of scopolamine." 06/01/2004 - "Presumed central anticholinergic syndrome from inadvertent intravenous hyoscine hydrobromide (scopolamine) injection."
4.	AntidotesIBA 03/01/2015 - "Physostigmine is the antidote for anticholinergic syndrome." 01/01/1979 - "Eserine: an antidote of the anticholinergic syndrome." 09/25/2019 - "Her clinical symptoms (decreased consciousness, mydriasis, confusion, hallucinations and urine retention) indicated anticholinergic syndrome that was effectively treated with the antidote physostigmine. " 06/01/1984 - "Physostigmine salicylate has been used as an antidote for the anticholinergic syndrome of tricyclic overdose, but probably offers less in maprotiline overdose. " 08/20/1977 - "The use of physostigmine as a specific antidote for the anticholinergic syndrome has been very successful; the incidence of this syndrome as a result of poisoning by tricyclic antidepressants is increasing. "
5.	Orphenadrine (Disipal)FDA LinkGeneric 04/01/2000 - "Central anticholinergic syndrome from orphenadrine in a 3 year old." 12/13/1975 - "A case of central anticholinergic syndrome after an overdose of orphenadrine citrate (Norflex), treated with tetrahydroaminacrine (THA, Tacrine) is presented. " 11/01/1991 - "We discuss the underlying physiology and manifestations of anticholinergic overdose, the specific manifestations of orphenadrine overdose, and the current recommendations regarding the utilization and toxicity of physostigmine in the treatment of anticholinergic syndromes and orphenadrine intoxication." 03/01/1982 - "Although physostigmine may be useful in the treatment of the anticholinergic syndrome it has, at least in the rat, no favourable effect on the respiratory insufficiency, due to overdoses of orphenadrine and imipramine. "
6.	VitaminsIBA 11/01/2005 - "Physiostigmine is effective in delirium caused by anticholinergic syndrome; vitamins may be useful in alcoholics; melatonin use has been suggested in order to prevent and treat delirium by normalizing sleep-wake cycle alterations. "
7.	Neostigmine (Neostigmine Bromide)IBA 08/01/2000 - "To our knowledge, this case is the first reported of central anticholinergic syndrome occurring after ingestion of Solanum pseudocapsicum in a child and the first report of a complete and rapid remission after intravenous neostigmine methylsulfate administration." 08/01/2000 - "A female with central anticholinergic syndrome responsive to neostigmine."
8.	MelatoninIBA 11/01/2005 - "Physiostigmine is effective in delirium caused by anticholinergic syndrome; vitamins may be useful in alcoholics; melatonin use has been suggested in order to prevent and treat delirium by normalizing sleep-wake cycle alterations. "
9.	Imipramine (Janimine)FDA LinkGeneric 03/01/1982 - "Although physostigmine may be useful in the treatment of the anticholinergic syndrome it has, at least in the rat, no favourable effect on the respiratory insufficiency, due to overdoses of orphenadrine and imipramine. "
10.	BromidesIBA 12/01/1983 - "We concluded that methyl atropine bromide is superior to atropine sulphate because it does not produce side effects which may cause the central anticholinergic syndrome. "

Therapies and Procedures

1.	Therapeutics 08/01/2005 - "Besides its well established use in the antagonism of neuromuscular blockades and the therapy of central anticholinergic syndrome (CAS), results of controlled studies and case reports suggest other favourable indications such as the prevention and therapy of postanaesthetic shivering and the treatment of various types of intoxication and delirium. " 04/01/1987 - "[Therapy of the anticholinergic syndrome in poisonings]." 02/16/2021 - "In contrast, use of therapy with intravenous physostigmine in the case of anticholinergic syndrome is restricted due to concerns about safety and dosing. " 11/10/2000 - "Symptoms, differential diagnosis, toxicology and physostigmine therapy of anticholinergic syndrome]." 01/01/1998 - "Central anticholinergic syndrome due to Jimson weed physostigmine: therapy revisited?"
2.	Anesthesia 03/01/2004 - "Now that these agents are rarely administered, anesthesia-related anticholinergic syndrome is currently infrequently reported. " 03/01/2004 - "Anticholinergic syndrome after anesthesia: a case report and review." 01/01/1989 - "Central anticholinergic syndrome (CAS) in anesthesia and intensive care." 07/01/2010 - "[Neurological complications following anesthesia--part I. Perioperative stroke, postoperative visual loss, anticholinergic syndrome]." 04/01/1995 - "[Central anticholinergic syndrome after propofol anesthesia]."
3.	General Anesthesia 09/01/2014 - "Central anticholinergic syndrome (CAS) following general anesthesia (GA) is a well known syndrome in children and adults. " 02/01/2002 - "This case illustrates the importance of considering central anticholinergic syndrome as a differential diagnosis in children if prolonged sedation after general anesthesia occurs." 07/01/1991 - "This report presents a case of central anticholinergic syndrome after general anesthesia in a patient with severe coronary heart disease. " 09/01/2012 - "The therapeutic approach for the central anticholinergic syndrome after application of cycloplegic eye drops in a premature infant patient who was scheduled for laser photocoagulation under general anesthesia is reviewed in the light of the relevant literature. " 03/01/2004 - "Anticholinergic syndrome was once a common phenomenon after general anesthesia because of the frequent administration of the anticholinergic agents atropine and scopolamine. "
4.	Premedication 07/01/1997 - "Two patients presented with very different signs of central anticholinergic syndrome following general anaesthesia for which they had received premedication with hyoscine. " 01/01/1982 - "[Physostigmine reversal of central anticholinergic syndrome induced by midazolam/fentanyl, benzoctamine/buprenorphine and etomidate/carticaine or by atropine/promethazine/pethidine for premedication? "
5.	Critical Care (Surgical Intensive Care) 01/01/1991 - "[Central anticholinergic syndrome in intensive care patients]." 01/01/1989 - "Central anticholinergic syndrome (CAS) in anesthesia and intensive care."