The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome
| Autor: | Shashikanth Ambati, Molly Boyd, Mitchell Zekhtser, Erin Carroll |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Polypharmacy
medicine.medical_specialty Physostigmine RC86-88.9 medicine.drug_class business.industry medicine.medical_treatment Medical emergencies. Critical care. Intensive care. First aid Case Report Critical Care and Intensive Care Medicine medicine.disease medicine Anticholinergic Intubation Dexmedetomidine Adverse effect Intensive care medicine business Hypopnea Toxidrome medicine.drug |
| Zdroj: | Case Reports in Critical Care Case Reports in Critical Care, Vol 2021 (2021) |
| ISSN: | 2090-6439 2090-6420 |
| DOI: | 10.1155/2021/7590960 |
| Popis: | Background. We report two pediatric cases of anticholinergic toxidrome, including the youngest reported to date, in which standard therapeutic strategies were either contraindicated or ineffective, while treatment with dexmedetomidine was rapidly efficacious with no adverse effects. Moreover, with the recent shortage of physostigmine, we highlight an alternative treatment in this clinical setting. Case Summaries. In case 1, a two-year-old had an overdose presenting with an anticholinergic toxidrome. However, his hypopnea precluded the use of benzodiazepines due to the high likelihood of intubation. In case 2, a 14-year-old had a polypharmacy overdose inducing agitated delirium that was refractory to high-dose benzodiazepines. Due to the unknown ingestion, physostigmine was avoided. In both cases, dexmedetomidine helped the patient remain calm and metabolize the ingestions. Conclusion. Our experience suggests that dexmedetomidine may be a useful adjunct in anticholinergic presentations in the setting of polypharmacy, when standard therapy is proven ineffective, contraindicated, or unavailable. |
| Databáze: | OpenAIRE |
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