Description
Doxylamine is an antihistamine and causes an anti-cholinergic syndrome after an overdose. The overdose can be accidental or deliberate. Patients exhibit confusion, blurry vision, fast heart rates, and dry hot skin and seizures.
Symptoms
Symptoms may be described as "Red as a beet" (red skin), "dry as a bone" (the skin is dry), "blind as a bat" (inability to accommodate the eyes causing blurry vision), "mad as a hatter" (patients are confused), "hot as a hare" (fever), "seizing like a squirrel" (seizures), fast heart rate, tremors, jerking motions, agitation.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. Tests will be performed to rule out other ingestions or other causes of the signs and symptoms.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Electrocardiogram (EKG)
Other Specific Tests: Urine or serum toxicology screen, acetameinophen (Tylenol) level, salicylate level, CPK (Creatinine Phospho Kinase).
Specialists:
Medical Toxicology
Workup:
A history and physical exam will be performed. Tests will be performed to rule out other ingestions or other causes of the signs and symptoms.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Electrocardiogram (EKG)
Other Specific Tests: Urine or serum toxicology screen, acetameinophen (Tylenol) level, salicylate level, CPK (Creatinine Phospho Kinase).
Specialists:
Medical Toxicology
Treatment
The patient is supported with supplemental oxygen and intravenous fluids. Gastric lavage ("pumping the stomach") and treatment with activated charcoal may be recommended. Sedation with benzodiazepines (Valium, Ativan) is sometimes necessary. Severe intoxications may require a breathing tube. If the symptoms are severe physostigmine may be administered.