Danze L K, Langdorf M I
Department of Medicine, University of California, Medical Center, Irvine, Orange 92668.
J Emerg Med. 1991 Nov-Dec;9(6):453-7. doi: 10.1016/0736-4679(91)90217-4.
A 3-year-old boy developed confusion, generalized tonic-clonic seizures, and sustained ventricular tachycardia following ingestion of an unknown quantity of orphenadrine (Norflex). Although refractory to precordial thump, synchronous cardioversion, and lidocaine, the ventricular tachycardia was reversed by intravenous administration of the tertiary acetylcholinesterase inhibitor physostigmine. We discuss the underlying physiology and manifestations of anticholinergic overdose, the specific manifestations of orphenadrine overdose, and the current recommendations regarding the utilization and toxicity of physostigmine in the treatment of anticholinergic syndromes and orphenadrine intoxication.
一名3岁男孩在摄入不明剂量的奥芬那君（Norflex）后出现意识模糊、全身性强直阵挛性癫痫发作和持续性室性心动过速。尽管胸前区捶击、同步心脏复律和利多卡因治疗均无效，但静脉注射叔胺类乙酰胆碱酯酶抑制剂毒扁豆碱后，室性心动过速得到逆转。我们讨论了抗胆碱能药物过量的潜在生理机制和表现、奥芬那君过量的具体表现，以及目前关于毒扁豆碱在治疗抗胆碱能综合征和奥芬那君中毒中的应用及毒性的建议。
