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Anticholinergic Poisoning

Anticholinergic Poisoning is a topic covered in the 5-Minute Emergency Consult.

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  • Central and peripheral cholinergic blockade
  • Depending on the drug involved, antagonism occurs at muscarinic (most common), nicotinic, or both receptors.
  • Onset of activity: 15–30 min after ingestion
  • Duration of effect: 2–24 hr


  • Many drugs contain anticholinergic properties:
    • Mild at therapeutic doses
    • Life threatening in overdose
  • Anticholinergic substances:
    • Antihistamines
    • Belladonna alkaloids and synthetic congeners
    • Antiparkinsonian drugs
    • Cyclic antidepressants
    • Antipsychotics (neuroleptics)
    • Mydriatics
    • Skeletal muscle relaxants (orphenadrine, cyclobenzaprine)
    • Antispasmodics
    • Mushrooms—Amanita muscaria, Amanita pantherina
    • Plants—deadly nightshade, mandrake, henbane
    • Jimson weed—smoked or ingested

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Rosen, Peter, et al., editors. "Anticholinergic Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307126/all/Anticholinergic_Poisoning.
Anticholinergic Poisoning. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307126/all/Anticholinergic_Poisoning. Accessed April 26, 2019.
Anticholinergic Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307126/all/Anticholinergic_Poisoning
Anticholinergic Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307126/all/Anticholinergic_Poisoning.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Anticholinergic Poisoning ID - 307126 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307126/all/Anticholinergic_Poisoning PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -