Frequently Asked Questions

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  • Drug Shortage Updates: Physostigmine (2026)

    Physostigmine has historically been the antidote of choice for anticholinergic toxicity-associated delirium. Due to a nationwide shortage of physostigmine, alternative treatment strategies may need to be considered in addition to benzodiazepines.

    The Minnesota Regional Poison Center has developed guidance summarizing potential alternatives during the shortage, including rivastigmine and donepezil, with practical considerations for use.

    Key Points

    • Rivastigmine (Exelon) may be considered in select patients with anticholinergic delirium, particularly:
      • Intubated anticholinergic patients to potentially help speed extubation
      • Patients who are awake, mildly agitated, and still able to take oral medications
    • Donepezil (Aricept) is not recommended at this time.

    A comparison of physostigmine, oral rivastigmine, rivastigmine patch, and oral donepezil—including usual dosing, onset, duration, efficacy, and monitoring considerations—is available in the full guidance document.

    View the full Physostigmine Shortage Guidance (PDF)

What Are the Updates to Acetaminophen Management?

What Is a Poison?

  • A poison is any substance that can cause harm when taken into or applied to the body
  • Exposure can occur by ingestion, inhalation, injection, or contact with the skin or eyes
  • Almost any substance can be harmful if exposure is large enough

When Should I Induce Vomiting?

  • Always contact a physician or the Poison Center before attempting to induce vomiting
  • Do not use home remedies such as syrup of ipecac, mustard, salt water, or inducing gag reflex

What If I Suspect Someone Has Been Poisoned?

  • If you suspect poisoning, call Poison Help at 1-800-222-1222
  • This number works anywhere in the United States and connects you to trained poison specialists

Who Are the Poison Center’s Most Frequent Callers?

  • Caregivers of children under the age of 5

When Is the Poison Center the Busiest?

  • Summer months, when children are more active indoors and outdoors
  • Evenings, especially between dinner and bedtime

What Are the Most Common Exposures?

  • Medications that resemble candy or flavored drinks
  • Common exposures include cough and cold syrups, asthma medications, liquid acetaminophen, and antibiotics

What Should I Do If My Pet Has Been Poisoned?

The North Dakota Poison Center does not manage animal poisonings. Please contact your veterinarian or one of the resources below. A fee may apply.

For more information, visit the Animal Poison Control Center.

If you have questions about poisoning or possible exposures, call Poison Help at 1-800-222-1222.