Atropine toxicity in acute cervical spinal injury

A patient with a C.3/C.4 fracture dislocation resulting in an incomplete tetraplegia was treated with Cimetidine 400 mg bd to prevent gastrointestinal bleeding and 0.6 mg of atropine 6 hourly. He developed symptoms of atropine poisoning in the form of hallucinations, confusion and dilated pupils whe...

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Bibliographic Details
Published in:Paraplegia 1984-12, Vol.22 (6), p.379-382
Main Authors: BAKER, J. H. E, SILVER, J. R
Format: Article
Language:English
Subjects:
Adult
Atropine - therapeutic use
Atropine - toxicity
Biological and medical sciences
Bradycardia - prevention & control
Cimetidine - therapeutic use
Drug toxicity and drugs side effects treatment
Hallucinations - chemically induced
Humans
Male
Medical sciences
Miscellaneous (drug allergy, mutagens, teratogens...)
Pharmacology. Drug treatments
Spinal Injuries - complications
Spinal Injuries - drug therapy
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Description
Summary:A patient with a C.3/C.4 fracture dislocation resulting in an incomplete tetraplegia was treated with Cimetidine 400 mg bd to prevent gastrointestinal bleeding and 0.6 mg of atropine 6 hourly. He developed symptoms of atropine poisoning in the form of hallucinations, confusion and dilated pupils when the total dosage of atropine was 2.8 mg. This is far below the toxic levels normally considered necessary to produce atropine poisoning. The patient recovered. In view of the fact that this combination of drugs may be used in spinal units to prevent gastrointestinal bleeding and bradycardia, this experience is reported.
ISSN:0031-1758
1362-4393
1476-5624
DOI:10.1038/sc.1984.61