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Case Reports
. 2006 Jan;23(1):82-5.
doi: 10.1136/emj.2004.017301.

Case of the month: rivastigmine (Exelon) toxicity with evidence of respiratory depression

S Sener  1 , M Ozsarac
Affiliations
Case Reports

Case of the month: rivastigmine (Exelon) toxicity with evidence of respiratory depression

S Sener et al. Emerg Med J. 2006 Jan.

Abstract

Rivastigmine, which has been approved by the US Food and Drugs Administration for the treatment of Alzheimer's disease, is a non-competitive reversible inhibitor of acetylcholinesterase. We present a case of rivastigmine toxicity at a dose of 90 mg, with evidence of respiratory depression. To our knowledge, this case report provides evidence of the highest rivastigmine ingestion recorded (90 mg) that caused respiratory depression but requiring only supportive intervention without the need for ralidoxime. Emergency physicians should strongly consider cholinesterase inhibitor (rivastigmine, galantamine, and tacrine) ingestion in patients who present with short and temporary organophosphate-like toxidromes.

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Conflict of interest statement

Competing interests: none declared

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