Indications

Cholinergic Intoxication (see Cholinergic Intoxication, [[Cholinergic Intoxication]])

• Formulation: SQ

Cigua Toxin Poisoning (see Cigua Toxin Poisoning, [[Cigua Toxin Poisoning]])

• Formulation: SQ
• Toxin: scaritoxin (which is a ciguatera-associated toxin) -> increases permeability of sodium channels, resulting in norepinephrine and acetylcholine release

“Death Rattle” in Dying Patient

• Formulation: SQ
• Clinical Efficacy
  • Systematic Review of Interventions for Noisy Breathing in the Dying Patient (Cochrane Database Syst Rev, 2008) [MEDLINE]
    • No Intervention (Pharmacologic or Non-Pharmacologic) Had Any Efficacy in Treating Death Rattle
  • Systematic Review of Antimuscarinic Drugs in zTreating Death Rattle (J Pain Symptom Manage. 2014) [MEDLINE]
    • Antimuscarinic Drugs (Glycopyrrolate, Scopolamine) Had No Efficacy in Treating Death Rattle (see Glycopyrrolate, [[Glycopyrrolate]])

Scorpion Envenomation (see Scorpion Sting, [[Scorpion Sting]])

• Formulation: SQ
• Associated Scorpion Species
  • Centuroides Exilicauda (Sculpuratus)
  • Centuroides Suffusus

Toxic Mushrooms (see Toxic Mushrooms, [[Toxic Mushrooms]])

• Formulation: SQ
• Associated Mushrooms
  • Boletus Calopus
  • Clitocybe Dealbata
  • Clitocybe Illudens
  • Inocybe Fastigiata
• Toxin: muscarine -> acts at muscarinic receptors in autonomic nervous system

Other

• Formulation: SQ
• Carbamate Intoxication (see Carbamates, [[Carbamates]])
• Organophosphate Intoxication (see Organophosphates, [[Organophosphates]])

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Pharmacology

• xxx

Metabolism

• xxxx

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Administration

• Glycopyrrolate (Robinul)
  • SQ
• Glycopyrrolate + Indacaterol (Ultibro Breezhaler) (see Glycopyrrolate + Indacaterol, [[Glycopyrrolate + Indacaterol]])
  • INH

Dose Adjustment

• Hepatic:
• Renal:

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Adverse Effects

Other Adverse Effects

• xxx
• xxx
• xxx

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References

• Interventions for noisy breathing in patients near death. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005177 [MEDLINE]
• Prevalence, impact, and treatment of death rattle: a systemic review. J Pain Symptom Manage. 2014;47:105–122 [MEDLINE]