Clinical features

• Anticholinergic effects (dilated pupils, dry mouth, ileus, retention of urine).

• Arrhythmias (particularly associated with prolonged QT interval and QRS waves).

• Hypotension related to arrhythmias and/or cardiac depression through Na + channel blockade.

• Hyper-reflexia with extensor plantars, visual hallucinations, coma and seizures. Drug levels do not correlate with severity.

• Metabolism is usually rapid and improvement can be expected within 24h.

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