Cases in Critical Care Medicine ( no 29): ORGANOPHOSPHATE POISONING -( ICU CHL HOSPITAL, INDORE )

Food for thought 🤠🙋‍♂️🙋‍♀️
Why does atropine cause fever & delirium in some pts when used for treating OPP?
ANS🤷‍♂️✔
Why Atropine Causes Fever
The anticholinergic effects of atropine can lead to hyperthermia (fever) through several mechanisms:
Reduced Sweat Production: Atropine inhibits sweat gland activity by blocking cholinergic muscarinic receptors. Sweat is a key mechanism for heat loss in the body, and reduced sweating can lead to increased body temperature.
Central Thermoregulatory Effects: Atropine can affect the central nervous system, particularly the hypothalamus, which is involved in regulating body temperature. By inhibiting the action of acetylcholine in the hypothalamus, atropine can disrupt normal thermoregulation, leading to hyperthermia.
By blocking acetylcholine's action in the brain, atropine disrupts normal neurotransmission, leading to cognitive impairment and Delirium
00:00:00 INTRO
00:46:35 ATROPINE
00:55:05 PAM

[@Haywire91]

In the beginning of the lecture around 3:00 time stamp, pin point constricted pupils diff diagnosis, someone said antipsychotics. How does antipsychotics give pinpoint pupils when they usually have anticholinergic actions on the side?

[@youngindiaintensivist7709]

@haywire ...Many antipsychotics, particularly the older typical antipsychotics, have anticholinergic properties.. While anticholinergic effects more commonly cause mydriasis (pupil dilation), in some cases, they can paradoxically result in miosis. This is due to the complex interactions of neurotransmitters in the central nervous system.
Alpha-Adrenergic Blockade
Some antipsychotics, such as chlorpromazine and thioridazine, also block alpha-adrenergic receptors. The blockade of alpha-1 adrenergic receptors can lead to miosis. This occurs because alpha-1 receptors normally mediate the contraction of the dilator pupillae muscle (which dilates the pupil). When these receptors are blocked, the constrictor pupillae muscle, which is controlled by the parasympathetic nervous system, predominates, resulting in pupil constriction.
it depends on which antipsychotic is in use