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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taken Overdose Of Avil. Have Palpitation, Weakness, Nausea, Convulsions. Treated With Dexamethasone. Solution?

respected sir,
i am aparamedic ,i got one case of drugs overdose(Avil),
pt. age 25 yrs,wt-50kgs
s/s:- palpitaition,general weakness,nausea,restlessness,burning sensation on upper and lower extrimity and convalsion.
vital:- pulse-120bpm,R.R-18bpm,BP:-100/70mmHg,temp-102DF,SKIN- pale,dry,pupils reacting to light.
Rx.i) inj dexamethason 4mg iv stat.
ii) IV drips RL 1
investigation-Hb,dlc,esr,electrolite all are normal.
after 7 days ,patient again in severe condition
please kindly advice me the parmanent solution of the case.
Sat, 10 Aug 2013
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General & Family Physician 's  Response
Hi thanks of serving humanity sir,

The advil contains Pheniramine which is antihistamine with anticholinergic properties.

The over dose of in your patient seem to be from anticholinergic toxicity
AND following are the symptoms
Flushing
Dry skin and mucous membranes
Mydriasis with loss of accommodation
Altered mental status (AMS)
Fever
Sinus tachycardia
Decreased bowel sounds
Functional ileus
Urinary retention
Hypertension
Tremulousness
Myoclonic jerking


Here are the things that needs to be done for reversal,

1) Get the patient to nearest emergency facility with advanced life support (ALS) capabilities. Focus primary assessment on circulatory, respiratory, and neurologic systems.
2) Obtain IV access and frequently monitor vital signs. Administer naloxone and thiamine and assess for hypoglycemia in patients with altered mental status.
3) Manage seizures with benzodiazepines.
4) Physostigmine is not recommended in the prehospital setting.
5)Avoid ipecac syrup and defer administration of activated charcoal unless a prolonged transport time is anticipated.

above mentioned were the emergency measures.
Now about the permanent solution is only ask patient away from advil/ matter of fact away from any anticholerginic, I appreciate your concern.



Hope its helpful, and comes back to you in time.


Thanks for the query.
Dr. JAY PATEL
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Taken Overdose Of Avil. Have Palpitation, Weakness, Nausea, Convulsions. Treated With Dexamethasone. Solution?

Hi thanks of serving humanity sir, The advil contains Pheniramine which is antihistamine with anticholinergic properties. The over dose of in your patient seem to be from anticholinergic toxicity AND following are the symptoms Flushing Dry skin and mucous membranes Mydriasis with loss of accommodation Altered mental status (AMS) Fever Sinus tachycardia Decreased bowel sounds Functional ileus Urinary retention Hypertension Tremulousness Myoclonic jerking Here are the things that needs to be done for reversal, 1) Get the patient to nearest emergency facility with advanced life support (ALS) capabilities. Focus primary assessment on circulatory, respiratory, and neurologic systems. 2) Obtain IV access and frequently monitor vital signs. Administer naloxone and thiamine and assess for hypoglycemia in patients with altered mental status. 3) Manage seizures with benzodiazepines. 4) Physostigmine is not recommended in the prehospital setting. 5)Avoid ipecac syrup and defer administration of activated charcoal unless a prolonged transport time is anticipated. above mentioned were the emergency measures. Now about the permanent solution is only ask patient away from advil/ matter of fact away from any anticholerginic, I appreciate your concern. Hope its helpful, and comes back to you in time. Thanks for the query. Dr. JAY PATEL