The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome
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 t...
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Wiley
2021-01-01
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Series: | Case Reports in Critical Care |
Online Access: | http://dx.doi.org/10.1155/2021/7590960 |
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author | Mitchell Zekhtser Erin Carroll Molly Boyd Shashikanth Ambati |
author_facet | Mitchell Zekhtser Erin Carroll Molly Boyd Shashikanth Ambati |
author_sort | Mitchell Zekhtser |
collection | DOAJ |
description | 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. |
format | Article |
id | doaj-art-8bd80c2fdc884d25a64f30e5e5a274c7 |
institution | Kabale University |
issn | 2090-6420 2090-6439 |
language | English |
publishDate | 2021-01-01 |
publisher | Wiley |
record_format | Article |
series | Case Reports in Critical Care |
spelling | doaj-art-8bd80c2fdc884d25a64f30e5e5a274c72025-02-03T01:26:59ZengWileyCase Reports in Critical Care2090-64202090-64392021-01-01202110.1155/2021/75909607590960The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic ToxidromeMitchell Zekhtser0Erin Carroll1Molly Boyd2Shashikanth Ambati3Department of Emergency Medicine, Albany Medical Center, Albany, New York, USADepartment of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts, USADepartment of Emergency Medicine, Albany Medical Center, Albany, New York, USADivision of Pediatric Critical Care Medicine and Department of Pediatrics, Albany Medical Center, Albany, New York, USABackground. 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.http://dx.doi.org/10.1155/2021/7590960 |
spellingShingle | Mitchell Zekhtser Erin Carroll Molly Boyd Shashikanth Ambati The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome Case Reports in Critical Care |
title | The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome |
title_full | The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome |
title_fullStr | The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome |
title_full_unstemmed | The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome |
title_short | The Role of Dexmedetomidine in Pediatric Patients Presenting with an Anticholinergic Toxidrome |
title_sort | role of dexmedetomidine in pediatric patients presenting with an anticholinergic toxidrome |
url | http://dx.doi.org/10.1155/2021/7590960 |
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