Tag: Anticholinergic toxicity

According to a review in the *American Family Physician*, many cases of serotonin syndrome go unrecognized due to their variable presentation. Understanding **what mimics serotonin syndrome** is crucial for proper diagnosis, as it can be confused with a variety of other conditions and medication toxicities. A mistaken diagnosis can lead to inappropriate treatment and potentially severe outcomes.

The true incidence of serotonin syndrome is unknown, as milder cases are often misdiagnosed or overlooked. This raises a critical question for clinicians: what can serotonin syndrome be confused with, and how can one differentiate it from its mimics?

In 2008, poison centers received over 1,000 calls regarding plants containing anticholinergic toxins, and atropine poisoning manifests as a classic anticholinergic toxidrome affecting both the central and peripheral nervous systems. It is crucial to recognize these signs for rapid intervention.

Cyclopentolate eye drops, routinely used for dilating pupils during eye exams, can lead to systemic anticholinergic toxicity if absorbed excessively. For severe systemic overdose, the specific antidote for cyclopentolate is physostigmine. This potent medication is reserved for life-threatening complications, especially those affecting the central nervous system.

According to the American Association of Poison Control Centers, tens of thousands of antihistamine exposures with anticholinergic effects are reported annually, highlighting the prevalence of these drugs. The range of clinical manifestations is broad, making it crucial to understand **what are the side effects of anticholinergic toxicity**.

Studies show that taking medications with strong anticholinergic properties is associated with a two-times greater risk of heat-related illness and death [1.2.1]. The critical question is, do anticholinergics increase body temperature and how significant is this risk?

Physostigmine is a natural alkaloid originally extracted from the Calabar bean, used historically as an ordeal poison and later for its medicinal properties. Today, its primary classification is a reversible acetylcholinesterase inhibitor, which explains its role as an antidote for overdoses involving anticholinergic substances.

According to medical experts, fever, or hyperthermia, is a classic and potentially dangerous symptom of anticholinergic toxicity, often described by the mnemonic "hot as a hare". This occurs when a person is exposed to excessive anticholinergic agents, leading to a cascade of effects on the body's thermoregulation.

Pharmacologically, physostigmine is a reversible cholinesterase inhibitor, a critical distinction from the highly toxic irreversible organophosphates used in nerve agents and pesticides. Derived from the Calabar bean, this compound temporarily blocks the enzyme that breaks down acetylcholine, impacting both the central and peripheral nervous systems. This reversible action defines its therapeutic application, primarily as an antidote in toxicology.

Over 600 drugs, including many common over-the-counter medications and prescriptions, possess anticholinergic properties, and their side effects can significantly impact a person's daily life. Understanding **what does anticholinergic feel like?** involves recognizing a wide spectrum of symptoms, ranging from simple discomforts to severe mental and physical distress.