Full recovery from a potentially lethal dose of orphenadrine ingestion using conservative treatment: a case report

Hum Exp Toxicol. 2010 Nov;29(11):961-3. doi: 10.1177/0960327110364642. Epub 2010 Mar 3.

Abstract

Intoxication by orphenadrine is uncommon. The clinical features consist of both central and peripheral anticholinergic effects. Ingestion of 2 to 3 g orphenadrine in an adult has been associated with fatality. A 46-year-old female was brought to our emergency department 1.5 hours after ingesting 40 tablets of 100 mg orphenadrine. She became stuporous 3 hours post-ingestion and developed generalized convulsions 1 hour later. Fifty-five hours post-ingestion, she had recovered and was found to have anterior shoulder dislocation. In addition, severe rhabdomyolysis and persistent nausea were observed. All of the above-noted toxic effects resolved with conservative treatment. Although orphenadrine intoxication can cause convulsions and hemodynamic instability, there is no available antidote and treatment remains supportive.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Charcoal / administration & dosage
  • Charcoal / therapeutic use
  • Cholinergic Antagonists / poisoning*
  • Female
  • Humans
  • Middle Aged
  • Orphenadrine / poisoning*
  • Poisoning / diagnosis
  • Poisoning / therapy
  • Radiography
  • Rhabdomyolysis / chemically induced
  • Rhabdomyolysis / diagnosis
  • Rhabdomyolysis / therapy
  • Seizures / chemically induced
  • Seizures / diagnosis
  • Seizures / therapy
  • Shoulder Dislocation / diagnostic imaging
  • Suicide, Attempted*
  • Treatment Outcome

Substances

  • Cholinergic Antagonists
  • Charcoal
  • Orphenadrine