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Reversal of orphenadrine-induced ventricular tachycardia with physostigmine |
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| Authors: | Lori K. Danze MD Mark I. Lanqdorf MD MHPE FACEP |
| Affiliation: | * Department of Medicine, University of California, Irvine, Medical Center, Orange, California, USA † Division of Emergency Medicine, University of California, Irvine, Medical Center, Orange, California, USA |
| Abstract: | A 3-year-old boy developed confusion, generalized tonic-Tonic seizures, and sustained ventricular tachycardia following ingestion of an unknown quantity of orphenadrine (Norflex). Although refractory to precordial thump, synchronous cardioversion, and lidocaine, the ventricular tachycardia was reversed by intravenous admiinistration of the tertiary acetylcholinesterase inhibitor physostigmine. We discuss the underlying physiology and manifestations of anticholinergic overdose, the specific manifestations of orphenadrine overdose, and the current recommendations refarding the utilization and toxicity of physostigmine in the treatment of anticholinergic syndromes and orphenadrine intoxication. |
| Keywords: | Author Keywords: orphenadrine overdose physostigmine ventricular tachycardia |
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