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Updated: May 21, 2026

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
Published on: February 11, 2019
Central anti-cholinergic syndrome induced by single therapeutic dose of atropine
Ashwin Panchasara1, Divyesh Mandavia, Ashish P Anovadiya
1Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar-364001, Gujarat, India.
Abstract:
A 55 years old male patient, who is planned for bronchoscopy developed central anti-cholinergic syndrome due to therapeutic dose of atropine. Withdrawal of atropine has improved the symptoms. Thereafter, instillation of atropine as eye drops leads to reappearance of symptoms. The reaction was definite according to Naranjo's algorithm. It was severe and definitely preventable according to Modified Hartwig and Siegel's scale and Modified Schumock and Thornton scale respectively. Central anti-cholinergic syndrome may be due to variation in the genetic susceptibility (Idiosyncrasy) to atropine. Idiosyncratic reaction on administration of atropine as a pre-anesthetic medication or eye drops should be kept in mind while prescribing.
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