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7423660 
Journal Article 
Acute cholinergic syndrome in a patient with mild Alzheimer's type dementia who had applied a large number of rivastigmine transdermal patches on her body 
Suzuki, Y; Kamijo, Y; Yoshizawa, T; Fujita, Y; Usui, K; Kishino, T; , 
2017 
1 
Clinical Toxicology
ISSN: 1556-3650
EISSN: 1556-9519 
TAYLOR & FRANCIS LTD 
ABINGDON 
55 
9 
1008-1010 
English 
28594244 
WOS:000410940900012 
A 91-year-old woman was transferred to our Emergency Medical Center and Poison Center with somnolence, hypertension (186/61 mm Hg), and repeated vomiting. Three hours later, 10 transdermal patches, each containing 18 mg of rivastigmine (9.5 mg/24 h), were found on her lower back and both thighs, when miosis, facial and trunk sweating, enhanced bowel sound, hypertension, and sinus tachycardia were noted. She was diagnosed with acute cholinergic syndrome due to rivastigmine poisoning. Her hypertension and sinus tachycardia peaked 8 and 5 h after all the patches were removed, respectively. Her symptoms subsided spontaneously after 17 h. 
acute cholinergic syndrome; Alzheimer’s type dementia; butyrylcholinesterase; Rivastigmine; transdermal patch; alpha amylase pancreas isoenzyme; cholinesterase; ketoprofen; prescription drug; rivastigmine; cholinesterase inhibitor; rivastigmine; aged; Alzheimer disease; anticholinergic syndrome; Article; back; blood pressure; body temperature; brain atrophy; breathing rate; case report; clinical article; computer assisted tomography; device removal; drug blood level; elimination half-life; enzyme activity; enzyme blood level; face; female; heart rate; hospital admission; human; hypertension; inguinal pain; intestine sound; leukocytosis; low back pain; miosis; neuroimaging; prescription; sinus rhythm; sinus tachycardia; somnolence; sweating; thigh; toxicity testing; transdermal patch; trunk; very elderly; vomiting; Alzheimer disease; chemically induced; cutaneous drug administration; drug effects; drug overdose; hypertension; Neurotoxicity Syndromes; pathophysiology; psychology; severity of illness index; Tachycardia, Sinus; transdermal patch; Administration, Cutaneous; Aged, 80 and over; Alzheimer Disease; Blood Pressure; Cholinesterase Inhibitors; Drug Overdose; Female; Heart Rate; Humans; Hypertension; Neurotoxicity Syndromes; Rivastigmine; Severity of Illness Index; Tachycardia, Sinus; Transdermal Patch 
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