Scopolamine als bestanddeel van een magistrale bereiding als zeldzame oorzaak van visuele hallucinaties

Scopolamine as a component of a magistral preparation causing visual hallucinations A 40-year-old patient had a first episode of visual hallucinations caused by the abuse of a magistral preparation containing scopolamine as an active component. The pharmacist used the outdated medicine as an over-the-counter (OTC) product. The patient was not aware of the potential risks in case of overuse. The overdose caused an isolated hallucinosis instead of hallucinations as a consequence of an anticholinergic syndrome. Firstly, it is important that the patient is sufficiently informed by the pharmacist concerning the delivered medication. Secondly, the doctor should actively inquire if the patient uses any OTC or magistral medicines. By doing this, rare clinical diseases caused by misuse of medication can be identified.

Neonatal Dhatura like poisoning - A premedication error in neonatal anesthesia

Overdosing of drugs sometimes produce fatal consequences. We report such a case of premedication dosing error in neonates with Glycopyrrolate leading to central anticholinergic syndrome (CAS) as in Dhatura poisoning. Accidental overdosing with glycopyrrolate resulted in symptoms like tachycardia, tachypnea, shock, hyperpyrexia, irritability and excessive crying. These symptoms resolved with symptomatic treatment. Errors can occur at any step of the path from drug prescription to administration. Medication errors are common and it should be immediately suspected in neonates with abnormal symptoms after injecting some drug, so that early diagnosis and treatment can be started timely. Identifying such medication errors is a challenge in neonatal care and should be a priority among caregivers in order to prevent future incidents and for patients’ safety.

Accidental Trihexyphenidyl Intoxication in a Seven-Year-Old Child: A Case Report from Senegal

Trihexyphenidyl or Artane® /Parkinane® is an anti-cholinergic drug belonging to the antimuscarinic class. It is used in the treatment of Parkinson’s disease and widely in psychiatry for the management of extrapyramidal side effects of neuroleptics. Its overdose leads to a central and peripheral anticholinergic syndrome. We report here the case of a seven-year-old Senegalese boy who developed signs of intoxication due to accidental ingestion of a high dose of trihexyphenidyl and recovered completely after administration of parenteral antipyretic, gastric lavage and supportive care in a paediatric setting.