Antimuscarinic Poisoning

Antimuscarinic poisoning can result from the intake of excessive doses of belladonna alkaloids, synthetic an-timuscarinic drugs, and drugs from other pharmacological groups that have significant antimuscarinic activity (Table 13.2).

Signs of peripheral muscarinic blockade (e.g., speech disturbances, swallowing difficulties, cardioac-celeration, and pupillary dilation) are most common at lower doses, whereas CNS effects (e.g., headache, restlessness, ataxia, and hallucinations) are more apparent after large doses. Antimuscarinic drugs can produce atrial arrhythmias, A-V dissociation, and ventricular tachycardia and fibrillation. Many cases of antimus-carinic poisoning can be managed by removing unab-

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