CASE STUDY : ANTICHOLINERGIC POISON

CASE STUDY : ANTICHOLINERGIC POISONING

History
A 33 year old woman was brought to the emergency room after being found in her apartment bound and gagged. on admission she was alert, but could remember only her name. vital signs included blood pressure, 150/100 mm hg, pulse 115 beats/min, respirations 16/min and rectal temperature 100°F.
The patient showed no signs of trauma, pupils were dilated (8 mm) and not reactive to light. heart and lung sounds and chest x ray film were all normal. ECG showed sinus tachycardia at a rate of 120 beats/min, PR interval of 0,18 sec, QRS of 0,08 sec, and QTc intervalnof 0,30 sec.
Examination of the abdomen indicated there were no bowel sounds. abdominal muscles were relaxed and the abdomen distended. the remainder of the physical examination was unremarkable. laboratory results are summarized in table 15.6
Therapy consisted of oral 50% dextrose in water and 50 g activated charcoal.
It was obvious that the woman had been poisoned, but the identity of poison could not be determined, she showed no improvement over the next several hours. however, about 12 hr later, her mental status began to improve.