1999
DOI: 10.1007/s001340051024
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Orphenadrine poisoning in a child: clinical and analytical data

Abstract: Orphenadrine is an anticholinergic drug used mainly in the treatment of Parkinson's disease. It has a peripheral and central effect and a known cardiotoxic effect when taken in large doses. We report the successful outcome of the treatment of a 2 1/2-year-old girl who accidentally ingested 400 mg of orphenadrine hydrochloride (Disipal). One hour after ingestion she presented neurological symptoms: confusion, ataxic walking, and periods of severe agitation. Generalized tonic-clonic seizures appeared resistant t… Show more

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Cited by 17 publications
(8 citation statements)
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“…7,8 Although rare, its use in the pediatric population has been reported for toxicity from diphenhydramine, orphenadrine, and antimuscarinic plants. [21][22][23] There are no prior reports using it for pediatric benztropine poisoning. In our patient, 1.5 mg of physostigmine rapidly and completely reversed his delirium.…”
Section: Discussionmentioning
confidence: 97%
“…7,8 Although rare, its use in the pediatric population has been reported for toxicity from diphenhydramine, orphenadrine, and antimuscarinic plants. [21][22][23] There are no prior reports using it for pediatric benztropine poisoning. In our patient, 1.5 mg of physostigmine rapidly and completely reversed his delirium.…”
Section: Discussionmentioning
confidence: 97%
“…Blood concentrations >500 ng/mL may cause toxic reactions and >5000 ng/mL may be lethal [3]. Accidental intoxication in children and a few cases of death have resulted from overdose of orphenadrine in schizophrenic patients [2][3][4]. Therefore, determination of blood orphenadrine levels and improved understanding of its pharmacokinetics may be help assess poisoned patients as well as improve monitoring in patients on the chronic therapy where indicated.…”
Section: Discussionmentioning
confidence: 97%
“…There is also reported cases of orphenadrine poisoning [2][3][4]. Blood concentrations of orphenadrine greater than 500 ng/mL may cause toxic reactions.…”
Section: Introductionmentioning
confidence: 93%
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“…It is, therefore, conceivable that, in patients with LQTS, orphenadrine can decrease the ‘repolarisation reserve’ (7), thereby enhancing the risk of the life‐threatening arrhythmias. Previous papers have pointed out the risk of cardiotoxicity, and especially of dangerous ventricular arrhythmias, after orphenadrine assumption (8–10). To the best of our knowledge, there is just one case of ventricular arrhythmias induced by low‐dose orphenadrine; in that case, there was neither QT prolongation nor hypokaliemia, and the authors hypothesised that the combination of the drug with a sodium channel‐blocking agent (propafenone) was probably responsible for the ventricular tachycardia (10).…”
Section: Discussionmentioning
confidence: 99%