Doxylamine Overdose (Unisom Overdose)
Description
Doxylamine is an antihistamine and causes an anti-cholinergic syndrome after an overdose. The overdose can be accidental or deliberate. Patients exhibit confusion, blurry vision, fast heart rates, and dry hot skin and seizures.
Symptoms
Red as a beet (red skin), dry as a bone (the skin is dry), blind as a bat (inability to accommodate the eyes causes blurry vision), mad as a hatter (patients are confused), hot as a hare (fever), seizing like a squirrel (seizures), fast heart rate, tremors, jerking motions.
Tests
A history and physical exam will be performed. Tests will be done to rule out other ingestions or other causes of the signs and symptoms.
- CBC
- Chem 12
- EKG
Treatment
The patient is supported with supplemental oxygen and intravenous fluids. Sedation with benzodiazepines (valium, ativan) is sometimes necessary. Severe intoxications may require a breathing tube. If the symptoms are severe physostigmine can be administered. (The antidote,physostigmine, may be indicated if diagnosis is uncertain, or symptoms are difficult to control. For more information and help call your local poison center at 1-800-222-1222.
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