Transdermal rivastigmine as a therapeutic option in severe diphenhydramine-induced anticholinergic toxicity: A case report and literature review.

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pharmacotherapy Pub Date : 2025-06-10 DOI:10.1002/phar.70031

Brian W Gilbert, Ruben D Santiago, Joel B Huffman, Nathaniel M Yoder, John C Hunninghake

引用次数: 0

Abstract

Diphenhydramine overdose is a common toxicological emergency characterized by anticholinergic symptoms such as delirium, hallucinations, and cardiovascular instability. Physostigmine, a centrally acting acetylcholinesterase inhibitor, is the standard antidote but is currently unavailable within the United States due to supply limitations. We present the case of a 21-year-old female with confirmed diphenhydramine overdose (3600 mg) who demonstrated rapid clinical improvement after administration of a 9.5 mg/24-h rivastigmine transdermal patch. This case supports growing evidence suggesting that rivastigmine may serve as a safe and effective alternative when physostigmine is not accessible.

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经皮拉米作为治疗严重苯海拉明引起的抗胆碱能毒性的选择：一个病例报告和文献复习。

苯海拉明过量是一种常见的毒理学紧急情况，其特征是抗胆碱能症状，如谵妄、幻觉和心血管不稳定。毒豆碱是一种中枢作用的乙酰胆碱酯酶抑制剂，是标准的解毒剂，但由于供应限制，目前在美国无法获得。我们报告了一名21岁的女性病例，确诊为苯海拉明过量（3600毫克），在给予9.5毫克/24小时的利瓦司汀透皮贴剂后，她的临床症状得到了迅速改善。这一案例支持了越来越多的证据表明，当毒豆碱无法获得时，雷瓦斯汀可作为一种安全有效的替代药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacotherapy 医学-药学

CiteScore

7.80

自引率

2.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.