Description

Sometimes it may be unclear if a patient has been exposed to an anticholinergic agent. Physostigmine is an anticholinesterase agent which normally produces cholinergic symptoms. Intravenous injection of a test dose of physostigmine can help separate those with anticholinergic drug intoxication from those who do not.


 

Test dose: 2 mg IV

 

Expected reactions in normal person with no exposure to an anticholinergic agent:

(1) salivation

(2) sweating

(3) slowing of heart rate

(4) intestinal hyperactivity

 

Failure to show these typical changes indicates that an anticholinergic agent is probably present.

 


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