Cholinergic syndrome

Delirium, e.g. post-narcotic delirium, somnolence or coma, is a common complication involving dementia, with fluctuating attention and consciousness and considerable morbidity. It is not always reversible and there is no specific treatment. Some of the accompanying central cholinergic syndromes can be reversed by ChEIs. 

Organophosphorus insecticides are readily absorbed from skin, mucous membranes, and gut. They inhibit cholinesterases, and patients present with an acute cholinergic syndrome. Symptoms depend in part on... 

Wermuth, C. G., Aminopyridazines-an alternative route to potent muscarinic agonists with no cholinergic syndrome. Farmaco 1993, 48, 253-274. 

Wermuth CG, Bourguignon J-J, Hoffmann R, Boigegrain R, Brodin R, Kan J-P, Soubrie P. SR 46559A and related aminopyridazines are potent muscarinic agonists with no cholinergic syndrome. Biorg. Med. Chem. Lett., 1992, 2, 833-836. 

CALCIUM CHANNEL BLOCKERS IRINOTECAN Risk oft serum concentrations of irinotecan with nifedipine. No cases of toxicity reported Inhibition of hepatic microsomal enzymes but exact mechanism uncertain at present Watch for symptoms/signs of toxicity (especially diarrhoea, an early manifestation of acute cholinergic syndrome)... 

IMATINIB IRINOTECAN t plasma concentrations of SN-38 (the active metabolite of irinotecan) and t toxicity of irinotecan, e.g. diarrhoea, acute cholinergic syndrome, interstitial pulmonary disease Inhibition of CYP3A4-mediated metabolism of SN-38 Peripheral blood counts should be checked before each course of treatment. Monitor lung function. The recommendation is to 1 dose of irinotecan by 25%... 

Irmotecan Nausea and vomiting cholinergic syndrome hypersensitivity reactions anaphylaxis diarrhoea Bone marrow depression diarrhoea colitis ileus alopecia renal impairment teratogenic... 

Lin CC, Chen JC. Medicinal herb Erycibe Henri Prain ( Ting Kung Teng ) resulting in acute cholinergic syndrome. J Toxicol CUn Toxicol 2002 40(2) 185-7. 

Dodds HM, Bishop JF, Rivory LP. More about irinote-can-related cholinergic syndrome induced by coadministration of oxaliplatin. J Natl Cancer Inst 1999 91(l) 91-2. 

Cholinergic syndrome Cerebellar syndrome, tremors Seizures... 

Cholinergic syndrome, delayed peripheral neuropathy (some)... 

Acute encephalopathy (cholinergic syndrome) neuromuscular transmission dysfunction acetylcholinesterase inhibition... 

Cholinergic syndrome (certain compounds) peripheral neuropathy (certain compounds only) acetylcholinesterase inhibition... 

Wermuffi, C.G., Bourguignon, J.-J., Hoffmann, R., Boigegrain, R., Brodin, R., et al. (1992) SR 46559 and related aminopyridazines are potent muscarinic agonist with no cholinergic syndrome. Biorg Med. Chem Lett. 2 833-836. 

Wermuth, C.G. (1993) Aminopyridazines — An alternative route to potent muscarinic agonist with no cholinergic syndrome. U Farmaco 48 253-274. 

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