The First Use of Pralidoxime in a Child With Rivastigmine Poisoning

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dc.contributor.authorSaz, Eylem Ulas
dc.contributor.authorYurtseven, Ali
dc.contributor.authorKilinc, Mehmet Arda
dc.contributor.authorSari, Ferhat
dc.contributor.authorAgin, Hasan
dc.date.accessioned2019-10-27T10:01:54Z
dc.date.available2019-10-27T10:01:54Z
dc.date.issued2018
dc.departmentEge Üniversitesien_US
dc.description.abstractObjective: The aim of this report is to describe the successful use of pralidoxime in a pediatric patient who accidentally ingested 12 mg of rivastigmine and presented to the emergency department with weakness, drowsiness, hyporeactivity to environmental stimuli, and full cholinergic syndrome. Case: The patient presented to the emergency department 2 hours after a suspected ingestion of rivastigmine. He was sleepy but oriented and cooperative, hypotonic, and hyporeflexic and has a Glasgow Coma Scale score of 13 (E3M6V4). Laboratory tests showed a low plasma cholinesterase levels of 2141 U/L (reference range, 5300-12 900 U/L), hyperglycemia (251 mg/dL), and leukocytosis with neutrophilia (21 900/mL, 75.2% neutrophils). Conclusions: Only 2 pediatric cases of rivastigmine poisoning have been reported in the literature, and there are no previous reports of using pralidoxime in the management of this poisoning. In the present case, intravenous pralidoxime (30 mg/kg) was administered twice at the fifth and sixth hours of ingestion for nicotinic and central effects. There is reasonable theoretical science to suggest pralidoxime in case of acetylcholinesterase inhibitor toxicity. We conclude that observed clinical improvement in weakness temporally associated with pralidoxime administration. Increased plasma cholinesterase activity after pralidoxime administration also makes it useful in this type of poisoning.en_US
dc.identifier.doi10.1097/PEC.0000000000001086en_US
dc.identifier.endpageE186en_US
dc.identifier.issn0749-5161
dc.identifier.issn1535-1815
dc.identifier.issue10en_US
dc.identifier.pmid28328690en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE184en_US
dc.identifier.urihttps://doi.org/10.1097/PEC.0000000000001086
dc.identifier.urihttps://hdl.handle.net/11454/29915
dc.identifier.volume34en_US
dc.identifier.wosWOS:000447172200003en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofPediatric Emergency Careen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectrivastigmineen_US
dc.subjectpoisoningen_US
dc.subjectpralidoximeen_US
dc.titleThe First Use of Pralidoxime in a Child With Rivastigmine Poisoningen_US
dc.typeArticleen_US

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