questionsmedicales.fr
Composés hétérocycliques
Composés hétérocycliques à cycles fusionnés
Composés hétérobicycliques
Indolizine
Indolizidines
Alcaloïdes indoliques
Physostigmine
Physostigmine : Questions médicales fréquentes
Diagnostic
5
Intoxication
Anticholinergiques
Tests sanguins
Évaluation neurologique
Signes cliniques
Mydriase
Paramètres vitaux
Évaluation clinique
Antécédents médicaux
Médicaments anticholinergiques
Symptômes
5
Sécheresse buccale
Difficultés à avaler
Fréquence cardiaque
Pression artérielle
Mydriase
Sensibilité à la lumière
Prévention
5
Prévention
Médicaments anticholinergiques
Conseils aux patients
Effets secondaires
Plantes toxiques
Éducation à la santé
Sécurité des médicaments
Prescriptions médicales
Gestion des médicaments
Inventaire
Traitements
5
Physostigmine
Traitement intraveineux
Acétylcholine
Inhibiteurs de l'acétylcholinestérase
Contre-indications
Asthme
Surveillance
Signes vitaux
Complications
5
Complications
Troubles cardiaques
Risques à long terme
Troubles cognitifs
Intervention rapide
Traitement approprié
Signes de complications
Douleurs thoraciques
Facteurs de risque
5
Facteurs de risque
Âge avancé
Historique médical
Troubles neurologiques
Environnement
Accès aux médicaments
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}
},
{
"@type": "Question",
"name": "Quels tests sont utilisés pour confirmer l'intoxication ?",
"position": 2,
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}
},
{
"@type": "Question",
"name": "Quels sont les signes cliniques d'une intoxication ?",
"position": 3,
"acceptedAnswer": {
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"text": "Les signes incluent confusion, tachycardie, sécheresse buccale et mydriase."
}
},
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"@type": "Question",
"name": "Comment évaluer la gravité de l'intoxication ?",
"position": 4,
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"@type": "Question",
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"@type": "Question",
"name": "Quels sont les symptômes de l'intoxication par anticholinergiques ?",
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"@type": "Question",
"name": "Comment se manifeste la sécheresse buccale ?",
"position": 7,
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"@type": "Question",
"name": "Quels sont les effets neurologiques possibles ?",
"position": 8,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les effets neurologiques peuvent inclure confusion, désorientation et convulsions."
}
},
{
"@type": "Question",
"name": "Quels signes vitaux sont affectés ?",
"position": 9,
"acceptedAnswer": {
"@type": "Answer",
"text": "La fréquence cardiaque et la pression artérielle peuvent être anormales."
}
},
{
"@type": "Question",
"name": "Comment reconnaître une mydriase ?",
"position": 10,
"acceptedAnswer": {
"@type": "Answer",
"text": "La mydriase se manifeste par des pupilles dilatées et une sensibilité à la lumière."
}
},
{
"@type": "Question",
"name": "Comment prévenir l'intoxication par anticholinergiques ?",
"position": 11,
"acceptedAnswer": {
"@type": "Answer",
"text": "Éviter l'usage inapproprié de médicaments anticholinergiques est crucial."
}
},
{
"@type": "Question",
"name": "Quels conseils donner aux patients ?",
"position": 12,
"acceptedAnswer": {
"@type": "Answer",
"text": "Informer les patients des effets secondaires potentiels des médicaments prescrits."
}
},
{
"@type": "Question",
"name": "Comment éduquer sur les risques des plantes toxiques ?",
"position": 13,
"acceptedAnswer": {
"@type": "Answer",
"text": "Éduquer sur les plantes toxiques et leurs effets anticholinergiques est essentiel."
}
},
{
"@type": "Question",
"name": "Quelles sont les mesures de sécurité à prendre ?",
"position": 14,
"acceptedAnswer": {
"@type": "Answer",
"text": "Conserver les médicaments hors de portée des enfants et suivre les prescriptions."
}
},
{
"@type": "Question",
"name": "Comment gérer les médicaments à domicile ?",
"position": 15,
"acceptedAnswer": {
"@type": "Answer",
"text": "Garder un inventaire des médicaments et vérifier les dates d'expiration régulièrement."
}
},
{
"@type": "Question",
"name": "Quel est le traitement principal de l'intoxication ?",
"position": 16,
"acceptedAnswer": {
"@type": "Answer",
"text": "Le traitement principal est l'administration de physostigmine par voie intraveineuse."
}
},
{
"@type": "Question",
"name": "Comment la physostigmine agit-elle ?",
"position": 17,
"acceptedAnswer": {
"@type": "Answer",
"text": "La physostigmine inhibe l'acétylcholinestérase, augmentant l'acétylcholine dans le système nerveux."
}
},
{
"@type": "Question",
"name": "Quels sont les effets secondaires de la physostigmine ?",
"position": 18,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les effets secondaires peuvent inclure nausées, diarrhée et bradycardie."
}
},
{
"@type": "Question",
"name": "Quand éviter l'utilisation de physostigmine ?",
"position": 19,
"acceptedAnswer": {
"@type": "Answer",
"text": "Elle est contre-indiquée en cas d'asthme ou de blocage cardiaque."
}
},
{
"@type": "Question",
"name": "Comment surveiller le patient après traitement ?",
"position": 20,
"acceptedAnswer": {
"@type": "Answer",
"text": "Il est essentiel de surveiller les signes vitaux et les effets secondaires."
}
},
{
"@type": "Question",
"name": "Quelles complications peuvent survenir avec l'intoxication ?",
"position": 21,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les complications incluent des troubles cardiaques et des crises convulsives."
}
},
{
"@type": "Question",
"name": "Comment l'intoxication affecte-t-elle le système nerveux ?",
"position": 22,
"acceptedAnswer": {
"@type": "Answer",
"text": "Elle peut provoquer des lésions cérébrales dues à une hypoxie prolongée."
}
},
{
"@type": "Question",
"name": "Quels sont les risques à long terme ?",
"position": 23,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les risques à long terme incluent des troubles cognitifs et des problèmes de mémoire."
}
},
{
"@type": "Question",
"name": "Comment prévenir les complications graves ?",
"position": 24,
"acceptedAnswer": {
"@type": "Answer",
"text": "Une intervention rapide et un traitement approprié sont essentiels pour prévenir les complications."
}
},
{
"@type": "Question",
"name": "Quels signes indiquent une complication ?",
"position": 25,
"acceptedAnswer": {
"@type": "Answer",
"text": "Des signes tels que des douleurs thoraciques ou des convulsions doivent alerter."
}
},
{
"@type": "Question",
"name": "Quels sont les facteurs de risque d'intoxication ?",
"position": 26,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les facteurs incluent l'âge avancé, l'usage de plusieurs médicaments et des antécédents médicaux."
}
},
{
"@type": "Question",
"name": "Comment l'usage de médicaments influence-t-il le risque ?",
"position": 27,
"acceptedAnswer": {
"@type": "Answer",
"text": "L'usage concomitant de médicaments anticholinergiques augmente le risque d'intoxication."
}
},
{
"@type": "Question",
"name": "Les enfants sont-ils plus à risque ?",
"position": 28,
"acceptedAnswer": {
"@type": "Answer",
"text": "Oui, les enfants sont plus vulnérables aux effets des anticholinergiques."
}
},
{
"@type": "Question",
"name": "Quel rôle joue l'historique médical ?",
"position": 29,
"acceptedAnswer": {
"@type": "Answer",
"text": "Un historique médical de troubles neurologiques ou cardiaques augmente le risque."
}
},
{
"@type": "Question",
"name": "Comment l'environnement peut-il influencer le risque ?",
"position": 30,
"acceptedAnswer": {
"@type": "Answer",
"text": "Un environnement avec un accès facile aux médicaments augmente le risque d'intoxication."
}
}
]
}
]
}
Expert en Médecine, Optimisation des Parcours de Soins et Révision Médicale
Validation scientifique effectuée le 07/04/2026
Contenu vérifié selon les dernières recommandations médicales
3 publications dans cette catégorie
Affiliations :
Minnesota Poison Control System, Minneapolis, MN, USA. Ann.Arens@hcmed.org.
Hennepin Healthcare, Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue, MC-R2, Minneapolis, MN, 55415, USA. Ann.Arens@hcmed.org.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
California Poison Control System, San Francisco Division, San Francisco, CA, USA.
San Francisco School of Pharmacy, University of California, San Francisco, CA, USA.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Pharmacy Department, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120 Heidelberg, Germany; Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: nadine.pinder@med.uni-heidelberg.de.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Institute of Medical Biometry and Informatics (IMBI), Heidelberg University Hospital, Marsilius-Arkaden, Tower West, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Pharmacy Department, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120 Heidelberg, Germany.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
Pharmacy Department, Heidelberg University Hospital, Im Neuenheimer Feld 670, 69120 Heidelberg, Germany.
Publications dans "Physostigmine" :
2 publications dans cette catégorie
Affiliations :
b Minnesota Poison Control System , Minneapolis , MN , USA.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Department of Biochemical and Chemical Engineering, TU Dortmund University, Dortmund, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Institute of Bioorganic Chemistry, Heinrich-Heine-University Düsseldorf at Forschungszentrum Jülich, Jülich, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Department of Biochemical and Chemical Engineering, TU Dortmund University, Dortmund, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Department of Biochemical and Chemical Engineering, TU Dortmund University, Dortmund, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Department of Chemistry and Chemical Biology, TU Dortmund University, Dortmund, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Parasite Chemotherapy Unit, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland.
University of Basel, 4001 Basel, Switzerland.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Institute of Bioorganic Chemistry, Heinrich-Heine-University Düsseldorf at Forschungszentrum Jülich, Jülich, 44227 Nordrhein-Westfalen, Germany.
Institut für Bio- und Geowissenschaften: Biotechnologie (IBG-1), Forschungszentrum Jülich, Jülich, 52428 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Department of Biochemical and Chemical Engineering, TU Dortmund University, Dortmund, 44227 Nordrhein-Westfalen, Germany.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Internal Medicine, University of Arizona College of Medicine - Tucson, Tucson, USA.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Internal Medicine, University of Arizona College of Medicine - Tucson, Tucson, USA.
Publications dans "Physostigmine" :
1 publication dans cette catégorie
Affiliations :
Internal Medicine, University of Arizona College of Medicine - Tucson, Tucson, USA.
Publications dans "Physostigmine" :
Anecdotally, cholinergic stimulation has been used to treat delirium and reduce cognitive dysfunction....
The aim of this investigation was to evaluate whether physostigmine reduced the incidence of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in patients undergoing liver re...
This was a double-blind, randomised, placebo-controlled trial. Between 11 August 2009 and 3 March 2016, patients were recruited at the Charité - Universitätsmedizin Berlin in Germany. Follow-ups took ...
This single-centre study was conducted at an academic medical centre....
In total, 261 participants aged at least 18 years scheduled for elective liver surgery were randomised. The protocol also included 45 non-surgical matched controls to provide normative data for POCD a...
Participants were allocated to receive either intravenous physostigmine, as a bolus of 0.02 mg kg-1 body weight followed by 0.01 mg kg-1 body weight per hour (n = 130), or placebo (n = 131), for 24 h ...
Primary outcomes were POD, assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-4-TR) twice daily up to day 7 after surgery, and POCD assessed via the CANTAB neuropsychologica...
In total, 261 patients were randomised, 130 to the physostigmine and 131 to the placebo group. The incidence of POD did not differ significantly between the physostigmine and placebo groups (20 versus...
Physostigmine had no effect on POD and POCD when applied after induction of anaesthesia up to 24 h....
DOI 10.1186/ISRCTN18978802, EudraCT 2008-007237-47, Ethics approval ZS EK 11 618/08 (15 January 2009)....
Emergence delirium is a well-known phenomenon that may be encountered after general anesthesia. A common approach to this issue is to risk stratify patients preoperatively and treat them postoperative...
In "Adverse Effects of Physostigmine" by Arens et al in the July 2019 issue of JMT, reference #27 contains an error....
Introduction - Our aim is to present a rare case where a child had delirium manifestation after instillation of cyclopentolate. Case presentation - A 7-year old patient was seen in our outpatient clin...
Recurrent physostigmine shortages present a challenge to healthcare providers treating antimuscarinic delirium. Other centrally acting acetylcholinesterase inhibitors such as rivastigmine may represen...
A 48-year-old female presented to an emergency department after ingesting 3.75 g (41.2 mg/kg) of diphenhydramine. She had antimuscarinic delirium with a presenting serum diphenhydramine concentration ...
Transdermal rivastigmine may be a useful treatment alternative or adjunct during physostigmine shortage for antimuscarinic delirium and has a long duration of action without aspiration risk. Muscarini...
The alkaloid physostigmine is an approved anticholinergic drug and an important lead structure for the development of novel therapeutics. Using a complementary approach that merged chemical synthesis ...
Physostigmine is the preferred treatment for antimuscarinic toxicity. Its use has a clear biological rationale and is supported by extensive clinical use which demonstrated effectiveness and safety....
Physostigmine fell out of widespread use in the 1980s due to safety concerns; however, more recent research has demonstrated that its safety profile is better than previously thought. These studies ha...
The National Poison Data System was queried for cases of patients aged 0-18 years that involved single-substance exposures to antimuscarinic xenobiotics that were reported to a poison center between J...
A total of 694,132 cases were reviewed, and 150,075 were included for analysis. Nearly 5% (7562/150,075) of patients received specific pharmacological therapy with benzodiazepines, physostigmine, or b...
Physostigmine frequency of use was low overall, but when used, was associated with less severe outcomes when compared to benzodiazepines....
(-)-Phenserine ("phenserine") and (+)-phenserine (posiphen; buntanetap) are longer-acting enantiomeric analogs of physostigmine with demonstrated promise in the treatment of Alzheimer's and Parkinson'...
Toxicity from antimuscarinic agents precipitates a constellation of signs and symptoms; two of the most significant are agitation and delirium. Benzodiazepines are commonly used for treatment; physost...
This was a blinded, randomized clinical trial in patients presenting for antimuscarinic toxidrome. Inclusion criteria were: ≥10-<18 years old, at least one central and two peripheral antimuscarinic sy...
Ten (53%) subjects were enrolled in the lorazepam arm, 9 (47%) in the physostigmine arm. Diphenhydramine was the most common agent ingested (16, 84%). Fewer patients receiving physostigmine had deliri...
Physostigmine was superior to lorazepam in controlling antimuscarinic delirium and agitation after bolus dosing, and control of delirium after a 4-h infusion. There were no serious adverse events in e...