ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2018
Cholinergic Crisis Caused by Cholinesterase Inhibitors: a Retrospective Nationwide Database Study.
Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 42 citations in OpenAlex.
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- A Narrative Review on Toxidromes in the Psychiatric Population: Implications for Overdose Prevention.Journal of clinical medicine · 2025Review
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- Pyridostigmine-induced complete atrioventricular block in a patient with Musk antibody-negative myasthenia gravis a case report : Pyridostigmine-ind advanced AV block in MG patient with MuSK-neg.BMC cardiovascular disorders · 2025Article
- Advances in Cholinesterase Inhibitor Research-An Overview of Preclinical Studies of Selected Organoruthenium(II) Complexes.International journal of molecular sciences · 2024Review
- Cholinergic Crisis with Normal Serum Cholinesterase Levels due to Excessive Galantamine Ingestion: A Case Report.JMA journal · 2024Article
- Potentially inappropriate drug use in myasthenia gravis: a real-world population-based cohort study in Italy.Frontiers in neurology · 2023Article
- Hydroxybenzoic Acids as Acetylcholinesterase Inhibitors: Calorimetric and Docking Simulation Studies.Nutrients · 2022Article
- Pharmacological Management of Apathy in Dementia.CNS drugs · 2022Review
- Cholinergic Crisis Owing to Distigmine Bromide Complicated by Hyperosmolar Hyperglycemic State.Internal medicine (Tokyo, Japan) · 2021Article
- A Fluidics-Based Biosensor to Detect and Characterize Inhibition Patterns of Organophosphate to Acetylcholinesterase in Food Materials.Micromachines · 2021Article
- Profiling the Tox21 Chemical Collection for Acetylcholinesterase Inhibition.Environmental health perspectives · 2021Article
- Differential Impact of Severity and Duration ofFrontiers in cellular neuroscience · 2021Article
- Opposite changes in blood pressure and pulse rate in two patients with distigmine and rivastigmine intoxication.JA clinical reports · 2020Article
- A Practical Approach to Managing Patients With Myasthenia Gravis-Opinions and a Review of the Literature.Frontiers in neurology · 2020Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionIn contrast to information on the effects of organophosphate, pesticide, or environmental exposures, data on cholinergic crisis caused by pharmaceutical cholinesterase inhibitors are sparse. The present study aimed to describe the characteristics, demographics, and mortality of patients with cholinergic crisis caused by pharmaceutical cholinesterase inhibitors using a nationwide inpatient database in Japan.
methodsWe identified patients diagnosed with cholinergic crisis as a result of taking cholinesterase inhibitor medications in the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2016. We examined the patients' characteristics, treatments, and mortality.
resultsA total of 235 patients with cholinergic crisis were identified during the 69-month study period. Forty-eight patients required mechanical ventilation (20.4%), and 15 patients died (6.4%) in hospital. The median lengths of hospital stay and intensive care unit stay were 15 days (interquartile range, 6-42) and 4 days (2-8), respectively. Approximately half of all hospitalized patients required catecholamines, atropine, or mechanical ventilation, while the other half did not require any of these treatments. Patients who required catecholamines, atropine, or mechanical ventilation were more likely to die and had longer hospital stays.
conclusionsCholinergic crisis caused by pharmaceutical cholinesterase inhibitors is a rare but potentially life-threatening condition. Patients who require mechanical ventilation and catecholamines or atropine have a poorer prognosis.
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