{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:28:02Z","timestamp":1770208082721,"version":"3.49.0"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"1","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Practice and Cases in Emergency Medicine"],"abstract":"<p>Introduction: Antimuscarinic toxicity, which can cause delirium and unsafe behavior, may result from an adverse effect of prescribed medications or from non-medical substance use. Physostigmine shortages have prompted use of transdermal rivastigmine for management of antimuscarinic toxicity; however, symptom control is equivocal at standard dosing. Case Report: A patient with antimuscarinic toxicity was treated with physostigmine and transitioned to 26.6 milligrams\/24 hours transdermal rivastigmine for sustained symptom control. He experienced no adverse effects and tolerated floor admission. Discussion: There is mechanistic plausibility supporting safe, sustained control of antimuscarinic toxicity with high-dose transdermal rivastigmine. Central distribution is more rapid than serum distribution and higher doses correlate with a shorter time to peak concentration.<\/p>","DOI":"10.5811\/cpcem.49089","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T23:54:52Z","timestamp":1768607692000},"source":"Crossref","is-referenced-by-count":0,"title":["Antimuscarinic Toxicity Safely Managed with High-Dose Transdermal Rivastigmine: A Case Report"],"prefix":"10.5811","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1003-5798","authenticated-orcid":false,"given":"Christopher James","family":"Watson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie M.","family":"Burrill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William S.","family":"Jaffee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2026,1,16]]},"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt0f10d1kc\/qt0f10d1kc.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T02:00:39Z","timestamp":1770170439000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/0f10d1kc"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,29]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.49089","relation":{},"ISSN":["2474-252X"],"issn-type":[{"value":"2474-252X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}