title: Dermal reaction and bigeminal premature ventricular contractions due to neostigmine: a case report.
abstract: BACKGROUND
  Neostigmine is a frequently used acetylcholinesterase inhibitor administered to reverse muscular relaxation caused by nondepolarizing neuromuscular relaxants in patients recovering from general anesthesia. Severe allergic reactions and urticaria are rarely reported following the use of neostigmine bromide, and never with methylsulfate-containing drugs. In this case, bigeminal premature ventricular contractions added to urticaria provides a warning about the possibility of a life-threatening situation.
  
  
  METHODS
  We report the case of a 23-year-old Persian woman who presented with bigeminal premature ventricular contractions along with urticarial lesions on her arm and trunk as soon as she was administered neostigmine methylsulfate after undergoing a laparoscopy for ectopic pregnancy.
  
  
  CONCLUSIONS
  This case report could be of value not only for anesthesiologists who routinely use neostigmine but also for others who administer the pharmaceutical preparation in other situations. The report presents a rare case of drug reaction following neostigmine use. As a result, one should consider any drug a probable cause of drug reaction. The preparation of resuscitative facilities, therefore, is necessary prior to the prescription of the medication.
authors.affiliation: Anesthesia and Critical Care Department, Women Hospital & Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. yousefshahi@tums.ac.ir.
authors.forename: Fardin
authors.initials: F
authors.lastname: Yousefshahi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Anbarafshan
authors.forename: Patricia
authors.initials: P
authors.lastname: Khashayar