![]() This increased cholinergic activity overcomes muscarinic receptor blockade, transiently reversing the effects of the anticholinergic agents.It temporarily blocks the breakdown of acetylcholine, thus enhancing its effects at muscarinic and nicotinic receptors.Physostigmine is a reversible acetylcholinesterase inhibitor (similar to carbamate insecticides).Do not stop using any medications without first talking to your doctor.Physostigmine is the specific antidote to anticholinergic delirium and may be used for behavioural control in carefully selected cases. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Patients (or their caregivers) should seek immediate medical attention if they develop a gray discoloration of the skin, mouth, or nail bed nausea headache dizziness lightheadedness fatigue shortness of breath rapid or shallow breathing a rapid heartbeat anxiety and confusion. Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment with sodium nitrite. ![]() Close medical supervision is necessary when medications that can cause methemoglobinemia are used together. Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have anemia, diseases of the heart or lungs, blood circulation disorders, shock, sepsis, and certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M. ![]() Using sodium nitrite together with amyl nitrite may increase the risk of methemoglobinemia, a condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. Applies to: Cyanide Antidote Kit (amyl nitrite/sodium nitrite/sodium thiosulfate) and Cyanide Antidote Kit (amyl nitrite/sodium nitrite/sodium thiosulfate)
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