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Title: 常用量のジスチグミンによるコリン作動性クリーゼ
Other Titles: Cholinergic Crisis Induced by a Usual Dose of Distigmine Bromide
Authors: 早川, 峰司1 Browse this author →KAKEN DB
丸藤, 哲2 Browse this author →KAKEN DB
森本, 裕二3 Browse this author →KAKEN DB
武山, 佳洋4 Browse this author
中村, 宏治5 Browse this author
古根, 高6 Browse this author
松原, 泉7 Browse this author
Authors(alt): Hayakawa, Mineji1
Gando, Satoshi2
Morimoto, Yuji3
Takeyama, Yoshihiro4
Nakamura, Kouji5
Furune, Takashi6
Matsubara, Izumi7
Keywords: コリン作動性クリーゼ
Cholinergic crisis
Distigmine bromide
Anticholinesterase poisoning
Issue Date: May-2001
Publisher: 日本救急医学会
Journal Title: 日本救急医学会雑誌
Volume: 12
Issue: 5
Start Page: 256
End Page: 260
Abstract: 排尿困難に対して、コリンエステラーゼ阻害薬であるジスチグミンが古くから用いられている。今回、常用量のジスチグミンを4回内服したのみで、コリン作動性クリーゼからショック状態に陥った症例を経験したので、若干の文献的考察を加えて報告する。
Distigmine bromide is an anticholinesterase used to treat urinary retention. We describe a case of life-threatening cholinergic crisis induced by a usual oral dose of distigmine bromide for postoperative urinary retention. An 82-year-old man with mild chronic renal failure was transferred to our emergency room due to cholinergic crisis accompanied by cyanosis, hypotension, and consciousness disturbance. The patient was 10mg/day of distigmine bromide orally administered for 2 days. The patient's serum cholinesterase decreased to 3IU/l. Mechanical ventilation, fluid resuscitation, and inotropic support were started. A few days after admission, despite continuous low serum cholinesterase, his toxic symptoms almost disappeared. Extubation was done, and the patient had an event-free recovery. The possibility of cholinergic crisis should be considered when patients with renal failure are given distigmine bromide. During cholinergic crisis, toxic symptoms do not parallel serum cholinesterase. Cholinergic crisis should thus be treated while carefully observing clinical symptoms.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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