Antihistamines hallucinations

Zipeprol [34758-83-3] (58) is another European antitussive with a wide range of pharmacological effects, including antispasmodic, antihistaminic, and local anesthetic activities (85,86). It has been reported that zipeprol has been abused in Italy because high doses cause hallucinations (87). Spontaneous withdrawal symptoms similar to those of opiates have been observed withdrawal symptoms can also be precipitated by naloxone. Zipeprol can be... 

Differences in receptor sensitivity have been offered to explain the spectrum of unexpected drug responses observed in children. Neonates and young children are at increased risk to experience paradoxical CNS stimulation following antihistamine administration. Symptoms observed in pediatric cases of acute overdose include hallucinations, excitation, and seizures. A physiological explanation for this reaction has not been identified. Antihistamines should not be included in over-the-counter (OTC) cough and cold products recommended for infants and young children. 

Central Motor restlessness, progressing to maniacal agitation, psychic disturbances, disorientation, and hallucinations. Elderly subjects are more sensitive to such central effects, in this context, the diversity of drugs producing atropine-like side effects should be borne in mind e.g., tricyclic antidepressants, neuroleptics, antihistamines, antiarrhythmics, antiparkinsonian agents. 

Children For infants and children especially, an overdose of antihistamines may cause hallucinations, convulsions, or death. Mental alertness may be diminished. In the young child, dimenhydrinate may produce excitation. Do not give to children under 2 years of age unless directed by a physician. 

Pentazocine (Talwin) (see also page 252) Street Names Crackers, poor man s h oin, T s and R s> Ts and Rits (all refer to combinations w/ Ritalin) (brands Talwin, Talwin Nx [CIV]) Use Medically used as opioid analgesic euphoria similar to heroin when mixed w/antihistamines combined w/ methylphenidate (Ritalin) is new abuse combination Actions Agonist-antagonist narcotic naloxone, a narcotic antagonist added to Talwin (Talwin NX) has reduced incidence of abuse Effects Euphoria, hallucinations, skin necrosis w/ illicit injection route... 

In overdose, the antihistamines cause convulsions, hallucinations, excitement, ataxia, incoordination, and athetosis. On exam patients may exhibit fixed, dilated pupils with a flushed face, sinus tachycardia, urinary retention, dry mouth, and fever. At high doses the patient can become comatose, which is often followed by cardiorespiratory collapse and death within 2 to 18 hours (Babe and Serafin, 1996). Treatment of overdose is mainly supportive, with efforts to manage the anti-colinergic effects. 

Dronabinol (Marinof) [C-ll] [Anriemeric, Appetite Stimulant/ Antivertigo] Uses N/V associated w/ CA chemo appetite stimulation Action Antiemetic 4- V center in the medulla Dose Adults Peds. Antiemetic 5-15 mg/m2/dose q4-6h PRN Adults. Appetite stimulant 2.5 mg PO before lunch dinner max 20 mg/d Caution [C, ] Contra Hx schizophrenia, sesame oil hypersensitivity Disp Caps SE Drowsiness, dizziness, anxiety, mood change, hallucinations, depersonalization, orthostatic 4- BP, tach Interactions T Effects W/ anticholinergics, CNS depressants, EtOH 4- effects of theophylline EMS Use caution w/ sympathomimetics, can T hypertension and tach use caution w/ anticholinergics and antihistamines, can T tach concurrent EtOH use can T CNS depression this is a principal psychoactive substance present in marijuana OD May cause extreme psychiatric effects (anxiety, mood changes and depersonalization) keep pt in a quiet environment and provide reassurance activated charcoal may be effective... 

Anticholinergics are associated with many side effects including mood change, confusion, hallucinations, drowsiness, and cardiac irregularity.13,39 In addition, blurred vision, dryness of the mouth, nausea/ vomiting, constipation, and urinary retention are fairly common. Antihistamine drugs with anticholinergic properties are also used occasionally (Table 10-2). 

Some antihistamines, for example tripellenamine (often used in combination with pentazocine), have a particular abuse potential and are used by drug addicts. Psychiatric disturbances, dysphoria, depression, confusion, and hallucinations can occur while under the influence of an antihistamine or during drug withdrawal. Chronic parenteral abuse can cause skin lesions, muscular fibrosis, and vasculitis. 

To counteract the sedative effects of the classic antihistamines, combinations with stimulants, such as pemoline and prolintane, have been tried. The efficacy of such combinations has not been proven, but additional adverse effects such as irritability (120) and hallucinations (121) have been observed. 

In large doses, atropine induces stimulation of the CNS, which in humans is characterized by overactive coordinated movements, hallucinations, and delirium. After the stimulation has lasted for some time, depression sets in and may proceed to complete paralysis of the CNS, which is fatal through cessation of respiration. In infants, particularly those ingesting antihistamines, paradoxical excitement may occur subsequently followed by a more characteristic CNS depression. CNS manifestations may resemble acute psychosis characterized by incoherence, confusion, hallucinations, delusions, paranoia, and abnormal motor behavior. 

Overdose of M blockers Poisoning most commonly follows excessive ingestion of over-the-counter (OTC) antihistamines and cold medications, or attempts to induce hallucinations. Note that M-blocking side effects (and possible toxicity) occur with both tricyclic antidepressants and phenothiazines. Management is largely symptomatic, although physostigmine can be seful and may counter both peripheral and central effects. 

The acute poisoning that occurs with most antihistaminics does not cause severe CNS depression as would be expected based on their sedative properties, but is manifested by mydriasis, fever, flushing, CNS excitement, hallucinations, ataxia, athetosis, and convulsions. Some of these effects, which resemble those of atropine poisoning, may be due to their anticholinergic properties. Diazepam is an effective antidote to poisoning and should be used to reverse the CNS excitement and convulsions. 

Antimuscarinic dmgs (atropine, some antidepressarts and antihistaminics, jimsonweed, etc) Delirium, hallucinations, seizures, coma, tachycardia, hypertension, hyperthermia, mydriasis, decreased bowel sounds, urinary retention Control hyperthenaia physostigmine may be helpful, but not for tricyclic overdose... 

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