Atropine poisoning in children
Introduction
Introduction to children's atropine poisoning Atropine and scopolamine atropine-containing alkaloids include mandala, white mandala (foreign flower), medlar (day fairy), hawthorn, etc.; atropine synthetic substitutes have post-mato products, stomach rehabilitation (benazepam), anisodamine (654-2), Antan (benzone), and the like. The toxic effect is to block a series of reactions caused by acetylcholine receptors, and to stimulate and then inhibit the central nervous system. basic knowledge The proportion of illness: more common in adult atropine tablets, the incidence rate is about 0.006% - 0.009% Susceptible people: children Mode of infection: non-infectious Complications: coma, respiratory failure
Cause
Pediatric atropine poisoning etiology
Taking too much medicine or eating the roots, stems, and fruits of such plants can cause poisoning, the latter mostly occurring in the fall or early winter.
Prevention
Pediatric atropine poisoning prevention
The precautionary measure is to vigorously promote the mandala, which is toxic and inedible, to prevent the ingestion of such toxic plants, to avoid overdose or excess in the clinical use of belladonna mixture, atropine and purine preparation, and to closely observe clinical adverse reactions.
Complication
Pediatric atropine poisoning complications Complications, coma, respiratory failure
The severe one turned from madness to coma, blood pressure dropped, and eventually died of respiratory failure.
Symptom
Pediatric atropine poisoning symptoms common symptoms hoarseness irritability rash rash mad swallowing difficulty slow response
More than 30 minutes to 3 hours after eating, the initial symptoms are dry mouth, red skin, dry, no sweat, sometimes red rash, difficulty swallowing, hoarseness, followed by irritability, panic, embarrassment, auditory hallucinations, Phantom and ataxia, the first to have a tonic or sputum with moderate fever, dilated pupils, weakened or disappeared response to light, elevated blood pressure, weak pulse rate, after 12 to 24 hours by mania Turned to coma, blood pressure dropped, and eventually died of respiratory failure.
Symptoms of central nervous system excitability during scopolamine poisoning are not significant, but manifest as slow response, listlessness, and lethargy.
Examine
Pediatric atropine poisoning examination
Blood test
The total number of white blood cells is generally normal or slightly increased, and most neutrophils are above 0.65.
2. Urine check
If necessary, analyze the urine atropine, add a little nitric acid to the urine and evaporate to dryness on the water bath, and add 1 drop of potassium hydroxide alcohol solution. If it is atropine, it will become violet blue and quickly turn red.
3. Poison identification method
(1) Methotrexate (methamphetamine) test: 3 to 10mg subcutaneous injection of this drug, such as no saliva increase, tearing, sweating, peristalsis, etc., suggesting atropine poisoning.
(2) Cat eye test: 1 drop of urine from the sick child is dripped into the cat's eye, then the pupil of the cat's eye is enlarged and the atropine poisoning is indicated.
(3) Others: take the patient's gastric juice or urine, add fuming nitric acid, evaporate dry on the water bath, and add 1 drop of potassium hydroxide ethanol solution. If it appears purple blue, it will turn red quickly, suggesting atropine. Class drugs exist.
Brain CT and EEG examination are performed when necessary.
Diagnosis
Diagnosis and diagnosis of atropine poisoning in children
diagnosis
There is a clear history of taking poisons or children in autumn without any cause of convulsions, coma, dilated pupils, and the presence of Datura plants in the surrounding environment should be considered poisoning. The fruits or undigested tablets are found in the gastric juice and can be diagnosed.
Differential diagnosis
1. Identification with hibernation (chlorpromazine), phenacetin (promethazine) poisoning should be identified with hibernation, non-root poisoning, such poisoning without dilated pupils, skin flushing, empty movements, visual halls, etc. Performance, mainly sleepiness, pupil diminution, coma, respiratory failure.
2. With encephalitis, meningitis should be differentiated from encephalitis and meningitis. The latter has meningeal irritation, cerebrospinal fluid examination changes, and no flushing, no sweat and dilated pupils.
