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Physostigmine for Anticholinergic Toxicity? | Toxicology | #CodeBlueDebrief

Updated: Nov 24, 2023

Welcome to PHARMWYZE! Clinical pharmacotherapy content made for learners of all medicine backgrounds. Thanks for joining me on the Code Blue Debrief YouTube & Podcast series. The focus will be evidence-based medicine and pharmacotherapy topics for emergency medicine and critical care learners.

 


👾 Physostigmine is a reversal agent for anticholinergic toxicities. By inhibiting acetylcholinesterase, increased acetylcholine becomes available at the synapses. It is an excellent drug to reverse antimuscurinic poisonings. Unfortuanetely, it has a negative stigma from prior case reports associated with TCA deaths.


The Akorn manufacturer went bankrupt recently, leaving the US without product available for the market. Recently, the FDA announced they would allow temporary importation from a company in Germany.


Hello there, Pharmers and Friends, Mark with PHARMWYZE. I'm a board certified emergency medicine pharmacist. I make clinical pharmacotherapy content on the social medias. Thanks for joining me on the Code Blue Debrief: A Clinical Pharmacotherapy YouTube & Podcast Series. Make sure to hit the follow, subscribe, and notification bell as we get into the episode's topic. For this episode, we'll be discussing anticholinergic toxicity and the use of physostigmine.


Make sure to stop by my website at www.pharmwyze.com, or visit linktr.ee/pharmwyze for my SM accounts.


Social Media: linktr.ee/pharmwyze


 

References

Newton RW. JAMA . 1975 Mar 3;231(9):941-3.

Pentel P, Peterson CD. Ann Emerg Med . 1980 Nov;9(11):588-90.

Wang GS et al. Clin Toxicol (Phila). 2021 Aug;59(8):698-704.

Watkins JW et al. J Med Toxicol. 2015 Jun;11(2):179-84.

Fratta KA, Ginder M, Haggerty DA. The Journal of Emergency Medicine, Vol. 65, No. 4, pp. e366–e368, 2023

McCoy CE, Honda R. J Educ Teach Emerg Med. 2023 Jan 31;8(1):S25-S47.

Elkhazeen A et al. J Forensic Sci . 2023 Jan;68(1):339-342.

Nishtala PS, Salahudeen SJ, Hilmer SN. Expert Opin Drug Saf . 2016 Jun;15(6):753-68. https://www.fda.gov/drugs/drug-shortages/october-31-2023-temporary-importation-available-physostigmine-injection

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