Atropine toxicity caused by erroneous intranasal administration in a pediatric patient: case report

A 28-month-old boy mistakenly received intranasal atropine sulfate instead of Otrivin (xylometazoline hydrochloride) for the treatment of adenoid hypertrophy. Later on, he came to the emergency department with anticholinergic manifestations after the administration of multiple drops. The child prese...

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Bibliographic Details
Published in:Annals of Saudi medicine 2019-07, Vol.39 (4), p.279-282
Main Authors: Alaula, Lama S, Al-Kadi, Mohammad, Almajed, Abdullah, Alhedaithy, Riyadh
Format: Article
Language:English
Subjects:
Administration, Intranasal
Atropine - administration & dosage
Atropine - poisoning
Case Report
Case reports
Child, Preschool
Emergency Service, Hospital
Humans
Imidazoles - administration & dosage
Lorazepam - administration & dosage
Male
Medication Errors
Muscarinic Antagonists - administration & dosage
Muscarinic Antagonists - poisoning
Pediatrics
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Summary:A 28-month-old boy mistakenly received intranasal atropine sulfate instead of Otrivin (xylometazoline hydrochloride) for the treatment of adenoid hypertrophy. Later on, he came to the emergency department with anticholinergic manifestations after the administration of multiple drops. The child presented with a tonic-clonic seizure lasting for a few minutes, followed by a brief loss of consciousness, vomiting, agitation, and irritability, all of which were stabilized by a dose of intravenous lorazepam. Subsequently, he was admitted to the pediatric intensive care unit for observation. Afterwards, he developed agitation and unsteady gait, both of which resolved after receiving neostigmine. Eventually, the child became asymptomatic and was discharged home. To the best of our knowledge, only one similar case has been reported in the literature. SIMILAR CASES PUBLISHED: 1.
ISSN:0256-4947
0975-4466
DOI:10.5144/0256-4947.2019.279