See Treatment and Medication for more detail.Īntihistamines also have anticholinergic properties. Laboratory studies that may be helpful include the following: No specific diagnostic studies exist for anticholinergic overdoses.

Podcast 98 – Cyclic (Tricyclic) Antidepressant OverdoseĪnticholinergic Toxicity Updated: Oct 26, 2017.

Here are two additional resources suggested by the Massive TCA Overdose post:īy Chris Nickson, Last updated on from Life In The Fast Lane.

It has detailed, easy to review treatment strategies for TCA overdose.

Massive TCA Overdose from CritCare Cases of Emergency Medicine Cases.

Sodium bicarbonate should be considered in life-threatening circumstances in the prehospital setting if there is a protocol for its use.”

“Sodium bicarbonate is the first-line therapy if TCA ingestion is known or strongly suspected.

If glucose /= to 2 years: 2 ml/kg D25W IV

Get finger stick glucose for any altered mental status.

So here are the differential diagnoses of drug toxidromes from the section on Anticholergic Toxicity :ĭifferential Diagnoses

Structural (CNS)- brain injury, subdural hematoma, post-ictal, stroke, tumour, brain mets.Endocrinopathies – hypo-/hyper-cortisol, hypoglycemia, thyrotoxicosis.altered pH, hypo/hyper Na+ Ca++, acute liver or renal failure, diabetic ketoacidosis.Infections-PUS, pneumonia, urinary, skin/soft tissue, CNS infection.

Drugs-Overdose of prescription drugs, illicit drug toxicity, or withdrawl from drugs or illicit substances.And I used to review drugs that can cause AMS. Rosenberg states that in patients with fever and AMS you want to consider the DIMS mnemonic. Hans Rosenberg presents the case of a 59 year old man brought into the emergency department with fever, diaphoresis, altered mental status (AMS).Īnd Dr. The podcast and show notes above are an outstanding teaching resource and just need to be carefully reviewed.ĭr. I just listened to Best Case Ever 64 Salicylate Poisoning, Dec 2017 from Emergency Medicine Cases.

Altered mental status differential