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7449909 
Journal Article 
A case of rivastigmine toxicity caused by transdermal patch 
Lee, DH; Choi, YH; Cho, KH; Yun, SY; Lee, HM 
2011 
Yes 
American Journal of Emergency Medicine
ISSN: 0735-6757
EISSN: 1532-8171 
W.B. Saunders 
29 
6 
695.e1-695.e2 
English 
20708894 
WOS:000292306100026 
Rivastigmine is a carbamate cholinesterase inhibitor used in the treatment of dementia. Toxicity is expected to resemble poisoning from other carbamates and organophosphates with features of both muscarinic (salivation, lacrimation, urination, defecation, miosis, bronchorrhea, and bradycardia) and nicotinic (muscle weakness, fasciculations, and paralysis) stimulation. We present a case of rivastigmine toxicity caused by transdermal patch. After removal of patches, the patient's symptoms and signs were spontaneous recovery without atropine and oxime therapy. Emergency physicians should be aware of the signs of increased nicotinic, muscarinic, and central nervous system effects (seizure), which are the same as with organophosphate and carbamate toxicities, and strongly consider carbamate cholinesterase inhibitor (rivastigmine) overdose. © 2011 Elsevier Inc. All rights reserved. 
rivastigmine; abdominal pain; aged; article; case report; diarrhea; dizziness; drug intoxication; drug withdrawal; female; fluid therapy; human; Mini Mental State Examination; nausea; neurologic examination; priority journal; sweating; transdermal patch; treatment refusal; vomiting 
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