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Anticholingergic Syndrome

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Critical Care Toxicology

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Abstract

The anticholinergic syndrome is common and may result from exposures to many drugs or natural substances (Table 1). Anticholinergic effects are desired or intended effects for certain drugs (i.e., antispasmodics, mydriatics, and belladonna alkaloids) and are undesired or side-effects for other drugs (i.e., antihistamines, antidepressants, antipsychotics, and antiparkinsonians). Both prescription and over-the-counter drugs may have anticholinergic effects. Combined use of more than one drug with anticholinergic effects increases the risk of anticholinergic toxicity. The anticholinergic syndrome, also called the , has peripheral and central manifestations. The more serious adverse effects associated with large exposures to these agents are often a result of other physiologic properties of these agents rather than the anticholinergic effects.

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Authors and Affiliations

  1. Emergency Medicine, University of Colorado School of Medicine, Denver, CO, USA

    William J. Boroughf

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  1. William J. Boroughf
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Correspondence to William J. Boroughf .

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Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I.

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1.

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2.

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3.

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III.

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Boroughf, W.J. (2016). Anticholingergic Syndrome. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_133-1

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