Title: Altered Mental Status- Is It Anticholinergic Toxicity? <br/>Author: Jon Mark Hirshon<br/><a href='http://umem.org/profiles/faculty/96/'>[Click to email author]</a><hr/><p>
A patient presents with altered mental status for unclear reasons- could it be anticholinergic syndrome? </p>
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There are many medications (e.g. Beers Criteria, see pearl from March 5, 2017), farm products (e.g: organophosphate insecticides) and plants (e.g.: certain mushrooms), and chemical weapons (e.g.: nerve agents) that can cause this life-threatening toxidrome.</p>
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The quick mnemonic for anticholinergic poisoning is:</p>
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· Hot as a hare (hyperthermia)</p>
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· Red as a beet (flushed)</p>
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· Cry as a bone (decreased secretions)</p>
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· Blind as a bat (mydriasis)</p>
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· Mad as a hatter (delirium)</p>
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· Full as a flask (urinary retention)</p>
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<em><strong>Bottom line: </strong></em>Keep anticholinergic syndrome within your differential for a patient with altered mental status without a clear cause. </p>
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<fieldset><legend>References</legend>
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1) <a href="http://emedicine.medscape.com/article/812644-overview">http://emedicine.medscape.com/article/812644-overview</a></p>
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2) http://www.uptodate.com/contents/anticholinergic-poisoning</p>
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