open access

https://hdl.handle.net/2115/47092

Cholinergic Crisis Induced by a Usual Dose of Distigmine Bromide

日本語

Anticholinesterase poisoning

2001-05

日本救急医学会

日本救急医学会雑誌

12(5)

256-260

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.

学術雑誌論文

Accepted Manuscript

0915-924X

AN10284604