Cardiotoxicity from orphenadrine intoxication in humans

Area of Science:

• Clinical Toxicology
• Cardiovascular Pharmacology
• Autonomic Nervous System

Background:

• Orphenadrine is an anticholinergic drug with potential for overdose.
• Anticholinergic toxicity can manifest with severe cardiovascular complications.
• Autonomic nervous system (ANS) dysfunction is a suspected mechanism in Orphenadrine toxicity.

Purpose of the Study:

• To report on the clinical presentation and management of Orphenadrine intoxication.
• To investigate the role of the autonomic nervous system in cardiovascular side effects of Orphenadrine.
• To evaluate the outcomes of Orphenadrine overdose patients.

Main Methods:

• Retrospective case series of eight patients with Orphenadrine overdose.
• Detailed reporting of clinical signs, symptoms, and therapeutic interventions.
• Analysis of cardiovascular parameters and suspected etiological factors.

Main Results:

• All eight patients presented in a coma following a suicide attempt with Orphenadrine overdose.
• Significant cardiovascular side effects, including life-threatening arrhythmias, were observed.
• Patients recovered without specific antiarrhythmic or cardiokinetic drugs, receiving supportive care including respiratory and cardiovascular assistance, and forced diuresis, with some receiving Diazepam.

Conclusions:

• Orphenadrine intoxication presents with severe cardiovascular toxicity, likely mediated by the autonomic nervous system.
• Supportive care, including respiratory and cardiovascular assistance and forced diuresis, is effective in managing Orphenadrine overdose.
• Specific antiarrhythmic treatment may not be necessary in all cases of Orphenadrine-induced arrhythmias.