Anticholinergic agents intoxication

The autonomic effects of cannabis lead to tachycardia, peripheral vasodilatation, conjunctival congestion, hyperthermia, bronchodilatation, dry mouth, nystagmus, tremor, ataxia, hypotension, nausea, and vomiting, that is a spectrum of effects that closely resembles the consequences of overdosage with anticholinergic agents. Some individuals have sleep disturbances. Increased appetite and dry mouth are other common effects of cannabis intoxication. 

A. Assessment. Hyperthermia (temperature > 40°C or 104°F) may be a catastrophic complication of intoxication by a variety of drugs and toxins (Table 1-12). It may be caused by excessive heat generation because of sustained seizures, rigidity, or other muscular hyperactivity an increased metabolic rate impaired dissipation of heat secondary to impaired sweating (eg, anticholinergic agents) or hypothalamic disorders. 

Flushed red skin may be caused by carbon monoxide poisoning, boric acid intoxication, chemical burns from corrosives or hydrocarbons, or anticholinergic agents. It may also result from vasodilation (eg, phenothiazines or disulfiram-ethanol interaction). 

McDonough JH, Zoeffel LD, McMonagle J et al. (2000). Anticonvulsant treatment for nerve agent seizures anticholinergics versus diazepam in soman-intoxicated guinea pigs. Epilep Res, 38, 1-14. 

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