PT  - JOURNAL ARTICLE
AU  - S Sener
AU  - M Ozsarac
TI  - Case of the month: Rivastigmine (Exelon<sup>®</sup>) toxicity with evidence of respiratory depression
AID  - 10.1136/emj.2004.017301
DP  - 2006 Jan 01
TA  - Emergency Medicine Journal
PG  - 82--85
VI  - 23
IP  - 1
4099  - http://emj.bmj.com/content/23/1/82.short
4100  - http://emj.bmj.com/content/23/1/82.full
SO  - Emerg Med J2006 Jan 01; 23
AB  - 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.