Due to excess nicotine effects, ventilation support in the ICU may be required.
Medical Treatment: Atropine, IV infusion, starting dose of 2 mg / h
10 mg 0.9 percent in 200 mL of sodium chloride given over 5 hours as a controlled infusion.
Assessing degree of atropinization by increasing pupil size( not monitoring continuous pupil size atropinization), pulse rate, bronchial secretions and salivation.
Continuous IV infusion of 0.05 mg / kg / hour may be necessary.
Do not abruptly stop atropine therapy. Wean at a rate not exceeding 1-2 mL / hour. During this stage, it is important to monitor the patients condition as a worsening occurs usually a few days after ingestion.