Coma caused treatment

Hull M, Kottlors M, Braune S. Prolonged coma caused by low sodium and hypo-osmolarity during treatment with citalopram. J Clin Psychopharmacol 2002 22(3) 337-8. 

Table 7-2 shows the oral doses of atropine causing undesirable responses or symptoms of overdosage. Measures to limit intestinal absorption should be initiated without delay if the poison has been taken orally (see Chapter 64). For symptomatic treatment, intravenous physostigmine rapidly abolishes the delirium and coma caused by large doses of atropine, but carries some risk of overdose in mild atropine intoxication. Since physostigmine is metabolized rapidly, the patient may again lapse into coma within 1-2 hours, and repeated doses may be needed (see Chapter 8). 

Myxedema coma is the extreme expression of severe, long-standing hypothyroidism. In addition to supportive care and treatment of the precipitating cause, treatment with thyroid hormone is essential. Based on uncertain oral absorption, thyroid hormone generally is given parenterally (e.g., a loading dose of200-300 pug ofl T i intravenously followed by a second dose of 100 ptg 24 hours later). A daily maintenance dose is then continued intravenously until the patient has improved sufficiently for oral therapy. Because of its more rapid onset of action, some clinicians add L-T ... 

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