Treatment of Adolescent Antimuscarinic (Anticholinergic) Toxidrome
Märksõnad
Abstraktne
Kuupäevad
| Viimati kinnitatud: | 05/31/2020 |
| Esmalt esitatud: | 03/09/2017 |
| Hinnanguline registreerumine on esitatud: | 03/19/2017 |
| Esmalt postitatud: | 03/26/2017 |
| Viimane värskendus on esitatud: | 06/01/2020 |
| Viimati värskendus postitatud: | 06/03/2020 |
| Õppe tegelik alguskuupäev: | 03/29/2017 |
| Eeldatav esmane lõpetamise kuupäev: | 07/30/2020 |
| Eeldatav uuringu lõpetamise kuupäev: | 07/30/2020 |
Seisund või haigus
Sekkumine / ravi
Drug: Physostigmine
Drug: Lorazepam
Faas
Käerühmad
| Arm | Sekkumine / ravi |
|---|---|
| Experimental: Physostigmine Physostigmine 0.02 mg/kg IV bolus (max of 2 mg), which can be repeated at 10 minutes, followed by a 0.02 mg/kg/hr (max of 2 mg/hr) infusion for 4 hours. | Drug: Physostigmine Administration of physostigmine bolus followed by an infusion |
| Experimental: Lorazepam Lorazepam 0.05 mg/kg IV bolus (max 2 mg), which can be repeated at 10 minutes if inadequate patient response, followed by a Normal Saline infusion for 4 hours. | Drug: Lorazepam Administration of lorazepam bolus followed by normal saline infusion |
Abikõlblikkuse kriteeriumid
| Õppimiseks sobivad vanused | 10 Years To 10 Years |
| Uuringuks kõlblikud sood | All |
| Võtab vastu tervislikke vabatahtlikke | Jah |
| Kriteeriumid | Inclusion Criteria: - Age >=10 and < 18 years - Present to the Emergency Department or Intensive Care Unit for an antimuscarinic toxidrome from either a pharmaceutical agent such as antihistamine overdose, or natural toxins or products such as Datura stramonium - Antimuscarinic toxidrome will be defined with at least one central nervous system agitation effect (agitation, delirium, visual hallucinations, mumbling incomprehensible speech), and at least 2 peripheral nervous system adverse effect (mydriasis, dry mucus membranes, dry axillae, tachycardia, decreased bowel sounds). - Patients will also be required to have a RASS score of +2 to +4 on initial assessment. Exclusion Criteria: - History of seizures or seizure during acute clinical course - History of asthma or wheezing during clinical course Bradycardia (Heart Rate <60) - Concomitant use of atropine or choline ester or depolarizing neuromuscular blocker during present illness and hospital course - Diabetes gangrene, known intestinal obstruction or urogenital tract, vagotonic state - QRS interval > 120 ms on electrocardiogram - Known to be pregnant at the time of enrollment - Known ward of the state |
Tulemus
Esmased tulemusnäitajad
1. Comparison of RASS score between physostigmine and lorazepam. [Before and after each bolus, and hourly for 5 hours]
2. Comparison of the effectiveness in control of delirium between physostigmine and lorazepam. [Before and after each bolus, and hourly for 5 hours]
Sekundaarsed tulemusmõõdud
1. Safety and effectiveness of Physostigmine infusion in the setting of antimuscarinic toxidrome. [Before and after each bolus, and hourly for 4 hours]
