Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-05-06T21:59:32 RDF description of Massive atropine eye drop ingestion treated with high-dose physostigmine to avoid intubation - http://repository.healthpartners.com/individual/document-rn19756 Emergency Medicine public 13 10.5811/westjem.2011.7.6817 11249 Adverse Effects 2022-02-21T22:48:57.408-06:00 1 Drugs and Drug Therapy Poisoning document-rn19756 Massive atropine eye drop ingestion treated with high-dose physostigmine to avoid intubation Western Journal of Emergency Medicine <p>CASE: A 34-year-old male presented after ingesting 150 mg of atropine. He had altered mental status, sinus tachycardia, dry mucosa, flushed skin, and hyperthermia. Sequential doses of physostigmine, totaling 14 mg, were successful in reversing antimuscarinic toxicity and prevented the need to perform airway control with endotracheal intubation. At completion of treatment, heart rate and mental status had improved, and intubation was never performed. DISCUSSION: Atropine causes anticholinergic toxicity; physostigmine reverses this by inhibiting acetylcholinesterase. Atropine eye drop ingestions are rare. The 14 mg of physostigmine administered is much higher than typical dosing. It is likely the physostigmine prevented intubation. Atropine eye drops can be dangerous, and physostigmine should be considered in treatment.<p> 17078