Imagine that someone, either by mistake or for some other reason, has taken too much of a medicine, or as we call it, has overdosed. In such an emergency, serious situation, a special treatment to reverse the toxic effect of that medicine is an injection called Physostigmine. This is not something you can use at home, nor is it something you can buy from a pharmacy. This is a treatment that is given only in a hospital, under the strict supervision of doctors. So let's talk about this simply today.
What exactly is Physostigmine?
Simply put, Physostigmine is an antidote. That is, it can reverse the harmful and dangerous effects of certain medications when taken in excess. It is not given for overdoses of all medications, and is only used for a few specific medications that qualify for it.
This medicine is commonly sold under the name Antilirium. But remember, this is not a medicine you will ever be given at home. This is a treatment that is only given by doctors in a hospital's Emergency Treatment Unit (ETU) or Intensive Care Unit (ICU).
Things to inform the doctor before giving this medicine
Before deciding to give this treatment, it is extremely important to inform the doctor about your or the patient's complete health history, as using this medication with certain medical conditions can be risky.
| Do you have these conditions? | Why is notification important? |
|---|---|
| Asthma | This medicine may increase breathing difficulties. |
| Bowel obstruction | The condition may become serious due to the action of the medicine. |
| Diabetes | Blood sugar levels may be affected. |
| Difficulty urinating | This situation could get worse. |
| Gangrene conditions | There may be problems related to blood supply. |
| Heart disease | Effects such as decreased heart rate may occur. |
| Various allergies (Allergies) | If you have any allergies to physostigmine, sulfites, or other medications, foods, or dyes, you must disclose them. |
| Pregnancy or breastfeeding | If you are pregnant, expecting a baby, or breastfeeding, you must inform your doctor. |
How is this medicine administered to the body?
This is given as an injection. It can be given as an injection into a muscle or as a slow injection directly into a vein. The treating doctor decides which of these two methods to use.
Most importantly, this treatment is only provided by a trained doctor or nurse in a hospital or clinic.
Special care should be taken when administering this treatment to young children. Therefore, if you are giving this medicine to your child, talk to your pediatrician about it.
What if too much of this medicine enters the body?
This may seem like a strange problem, but even a drug given for treatment can be harmful if taken in excess. However, since Physostigmine is a drug that is given very carefully and in the prescribed dosage under medical supervision, the chances of this happening are very low. If there is any suspicion of such a thing, the medical team knows all the steps to take. Usually, if there is any suspicion of a drug overdose, we seek advice from the National Poisons Information Center at the Colombo National Hospital .
Other drugs that may interact with Physostigmine
Other medications you are taking can affect the way this medicine works. Therefore, it is important to give your doctor a complete list of all medications, herbal remedies, vitamins, and supplements you are taking. You should also tell your doctor if you smoke, drink alcohol, or use other drugs.
| Absolutely Avoid Taking This Medicine | |
|---|---|
| Quinine | Serious interactions may occur. |
| Use with caution with this medicine. | |
| Atropine | These two medications can act in opposite ways to each other. |
What are the possible side effects during treatment?
As with any medication, some side effects can occur when taking Physostigmine. The medical team will monitor you closely while you are receiving this treatment, so they can take action quickly if any problems arise.
| Side effect | Description |
|---|---|
| If any of these occur, notify the medical team immediately. | |
| Difficulty breathing | Shortness of breath, rapid breathing. |
| Excessive sweating | If the body suddenly becomes cold and sweats profusely. |
| Seizures | Body shaking or fainting. |
| Slow heartbeat | The medical team is always attentive to this. |
| Muscle weakness | Feeling of numbness in the limbs. |
| These are usually not serious, but tell your doctor if they persist. | |
| Increased saliva | Increased salivation. |
| Nausea and vomiting | Stomach upset and vomiting. |
| Stomach pain | Abdominal discomfort. |
Take-Home Message
- Physostigmine is a special, emergency injection used to treat overdoses of certain medications.
- This treatment is only given in a hospital, under the strict supervision of a trained medical team. It is never given for home use.
- It is essential to inform your doctor about any other medical conditions you have (such as asthma, heart disease) and all medications you are taking.
- If any serious side effects (difficulty breathing, seizures) occur during treatment, the medical team will intervene immediately.
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