title: Cholinergic symptoms with low serum cholinesterase from therapeutic cholinesterase inhibitor toxicity.
abstract: Although cholinesterase inhibitors have been frequently used in the treatment of Alzheimer disease, its effects on serum cholinesterase concentrations have been rarely described. We described significant depression of serum cholinesterase levels due to cholinesterase inhibitor toxicity from redundant use of donepezil and rivastigmine in a 78-year-old man. Recovery of serum cholinesterase level was noted upon drug discontinuation and cholinergic symptom resolution. Serum cholinesterase level can be used as a biomarker for central cholinesterase inhibitor toxicity.
authors.affiliation: NorthShore University HealthSystem-OMEGA, Glenbrook Hospital, Glenview IL; Pritzker School of Medicine, University of Chicago, Chicago, IL. Electronic address: jleikin@northshore.org.
authors.forename: Jerrold B
authors.initials: JB
authors.lastname: Leikin
authors.affiliation: Pritzker School of Medicine, University of Chicago, Chicago, IL; Department of Medicine, NorthShore University HealthSystem, Glenbrook Hospital, Glenview IL.
authors.forename: Victoria
authors.initials: V
authors.lastname: Braund
authors.affiliation: Illinois Poison Center, Chicago IL.
authors.forename: Carol
authors.initials: C
authors.lastname: DesLauris
mesh_terms: D000368:Aged; D001919:Bradycardia / Q000139:chemically induced*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D002802:Cholinesterases / Q000097:blood*; D000077265:Donepezil; D006801:Humans; D007189:Indans / Q000009:adverse effects*; D020961:Lewy Body Disease / Q000150:complications / Q000188:drug therapy*; D008297:Male; D015877:Miosis / Q000139:chemically induced*; D010300:Parkinson Disease / Q000150:complications; D048448:Phenylcarbamates / Q000009:adverse effects*; D010880:Piperidines / Q000009:adverse effects*; D000068836:Rivastigmine
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D048448:Phenylcarbamates; D010880:Piperidines; D000077265:Donepezil; D002802:Cholinesterases; D000068836:Rivastigmine