[Cholinergic crisis following administration of distigmine bromide: a case report].
The long-acting anticholinesterase, distigmine bromide (Ubretid), is widely used for the treatment of underactive neurogenic bladder. Therefore, we emphasize its hazardable side-effect of cholinergic crisis. A 78-year-old man with duodenal ulcer complained of nocturia, and was administered distigmine bromide 10 mg daily under the diagnosis of mild benign prostatic hypertrophy with underactive neurogenic bladder. It seemed that administration slightly improved his symptom but he developed bradycardia, dyspnea and drowsiness suddenly on the 4th day. Blood examination revealed extremely low cholinesterase in his serum, suggesting distigmine bromide intoxication. He was treated intensively with several intravenous injections of atropine, high-concentration oxygen and transfusion of fresh frozen plasma. Nevertheless, his condition did not recover, resulting in death of "cholinergic crisis" on the 6th day.
Yamanaka
Shigeki
S
Department of Urology, Kansai Medical University.
Fujita
Ichiro
I
Murota
Takashi
T
Kawakita
Mutsushi
M
Matsuda
Tadashi
T
D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000139:chemically induced*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D002802:Cholinesterases / Q000097:blood; D006801:Humans; D008297:Male; D011726:Pyridinium Compounds / Q000009:adverse effects*; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy
D002800:Cholinesterase Inhibitors; D011726:Pyridinium Compounds; D002802:Cholinesterases; C084645:distigmine