Cholinergic symptoms and QTc prolongation following donepezil overdose.

MedStar author(s):
Citation: American Journal of Emergency Medicine. 35(9):1386.e1-1386.e3, 2017 SepPMID: 28668178Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Alzheimer Disease/dt [Drug Therapy] | *Arrhythmias, Cardiac/ci [Chemically Induced] | *Cholinesterase Inhibitors/po [Poisoning] | *Indans/po [Poisoning] | *Piperidines/po [Poisoning] | Aged, 80 and over | Drug Overdose/co [Complications] | Drug Overdose/di [Diagnosis] | Electrocardiography | Humans | MaleYear: 2017Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0735-6757
Name of journal: The American journal of emergency medicineAbstract: Copyright (c) 2016. Published by Elsevier Inc.Donepezil is the most commonly prescribed acetylcholinesterase inhibitor for the treatment of Alzheimer's disease, an ailment that affects millions of older adult patients. By inhibiting the breakdown of acetylcholine in the central nervous system, donepezil has been shown to slow cognitive decline and improve patients' functional status. While donepezil is well-tolerated and generally considered safe at therapeutic doses, taking more than the prescribed dose could result in adverse cholinergic effects that range from mild gastrointestinal distress to serious cardiac dysrhythmias. We present a case of an 84-year-old man who developed gastrointestinal and cardiac disturbances after ingesting seven-times his daily dose of donepezil. As no specific antidote is available for donepezil overdose, this case highlights the importance of supportive care with particular attention to the management of cardiac dysrhythmias in patients displaying signs of toxicity.All authors: Aalam A, Mazer-Amirshahi M, Pourmand A, Redha W, Shay CFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-07-10
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28668178 Available 28668178

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Copyright (c) 2016. Published by Elsevier Inc.

Donepezil is the most commonly prescribed acetylcholinesterase inhibitor for the treatment of Alzheimer's disease, an ailment that affects millions of older adult patients. By inhibiting the breakdown of acetylcholine in the central nervous system, donepezil has been shown to slow cognitive decline and improve patients' functional status. While donepezil is well-tolerated and generally considered safe at therapeutic doses, taking more than the prescribed dose could result in adverse cholinergic effects that range from mild gastrointestinal distress to serious cardiac dysrhythmias. We present a case of an 84-year-old man who developed gastrointestinal and cardiac disturbances after ingesting seven-times his daily dose of donepezil. As no specific antidote is available for donepezil overdose, this case highlights the importance of supportive care with particular attention to the management of cardiac dysrhythmias in patients displaying signs of toxicity.

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