Overdose : מינון יתר

4.9 Overdose
Emergency measures, symptoms and antidotes:
In principle, the possibility of multiple intoxication should always be considered, for example, if several drugs are used with suicidal intention.
a) Symptoms of overdose:
The acute intoxication is characterized by nausea, vomiting, hyper-excitability, tremor, ataxia, blurred vision, lethargy, depression, dysarthria and cerebral seizures; in one case, malignant cardiac arrhythmia has been reported.
Acute toxic psychoses ranging from confusion with visual hallucinations to coma and myoclonus have been reported with concomitant administration of amantadine with other anti-Parkinson drugs.
b) Therapeutic measures in case of overdose:
A specific drug therapy or antidote is not known. In case of intoxication through the ingestion of film-coated tablets, induce vomiting or gastric lavage.
In addition, intensive monitoring measures are necessary for vitally threatening intoxications..
Therapeutically, liquid intake, acidification of the urine for the faster excretion of the substance, possibly sedation, anticonvulsive measures and anti-arrhythmic drugs (lidocaine i.v.) are also suitable.
For the treatment of neurotoxic symptoms (as described above), intravenous administration of 1- 2 mg physostigmine in adults may be attempted every 2 hours, in children 0.5 mg twice in intervals of 5 to 10 minutes, to a maximum dose of 2 mg. Due to the low dialyzability of Amantadine (about 5%) hemodialysis does not make sense.
It is recommended to especially monitor patients for possible QT prolongation and factors that favor the onset of TdP, e.g. electrolyte disorders (in particular hypokalemia and hypomagnesemia) or bradycardia.