- 作者：Umberto Raucci ; MD ; PhD&lowast ; ; ; Nicola Vanacore ; MD ; PhD&dagger ; ; Corrado Cecchetti ; MD&lowast ; ; Mario Salvatore Russo ; MD&Dagger ; ; Rossella Rossi ; MD&lowast ; ; Nicola Pirozzi ; MD&lowast ;
- 关键词：rivastigmine ; cholinergic syndrome ; toxicity ; poisoning ; cardiac effect
- 刊名：Journal of Emergency Medicine
- 出版年：July 2014
- 年：2014
- 卷：47
- 期：1
- 页码：21-25
- 全文大小：133 K
Case Report
A 3-year-old girl was admitted to the Emergency Department suspected of having ingested one or two pills of rivastigmine. The child was hyporeactive, with symptoms of altered mental status, sialorrhea, sweating, and diarrhea. Subsequently, she started showing signs of respiratory failure, severe tracheobronchial involvement, and gastric and abdominal distension. An electrocardiogram recorded frequent monomorphic ventricular ectopic beats with bigeminy and trigeminy. Long-term follow-up showed a transient dysrhythmia.
Conclusion
Poisoning with rivastigmine can be a life-threatening condition. Timely identification and appropriate management of the toxic effects of this drug are essential and often life-saving. This is particularly true in cases of cholinergic syndrome subsequent to drug poisoning. Patients with cholinergic syndrome should also be assessed for possible cardiac complications such as dysrhythmias. The main factors predisposing to the development of such complications are autonomic disorder, hypoxemia, acidosis, and electrolyte imbalance.