2/17/2023 0 Comments Lorazepam antidoteThe only documented adverse events in TCA cases were two episodes of diaphoresis out of 315 patients. There were no cases of respiratory distress. Cholinergic signs occurred in 6.4% of patients in prospective study diaphoresis, nausea, emesis, and incontinence were all manageable. The rate of seizures was 0.75% none resulted in significant sequelae. The rate of arrhythmias was 0.17% each event was self-limited. The overall positive response rate was nearly 80%. One thousand one hundred and ninety seven patients were treated with physostigmine. The following reports a 6-year retrospective review of the practice and a detailed prospective 1-year observational study of bedside use. It is given 0.02 mg/kg IV at a rate of 0.5 mg/min with repeat doses q1-2h PRN. At one toxicology center, physostigmine continues to be employed in the emergency department and acute hospital setting. A direct antidote is available, but not often used. Delirium is a common consequence of toxicity. Anticholinergic activity is relevant for many medicinal and natural toxins.
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