Hyoscine-N-butyl-bromide-induced hypotension and myocardial ischemia.
Hyoscine N-butyl bromide, also known as scopolamine, is a type of antimuscarinic agent. This drug is associated with numerous common side effects, including abdominal fullness, constipation, urinary retention, blurred vision, skin flushing, tachycardia, decreased sweating, and salivation. The most unfavorable side effect is hemodynamic instability. In the present case, hypotension and acute myocardial infarction developed after intravenous hyoscine injection as a premedication therapy for colonoscopy. It was difficult to differentiate the cause-effect relationship between myocardial infarction and hypotension. Because both conditions were present under drug effects, we considered 2 possible diagnoses. One was coronary spasm with cardiogenic shock, and the other was myocardial ischemic sequela due to shock status. The latter diagnosis was confirmed after a series of examinations.
Division of Cardiology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 441, Taiwan.
Guan-Liang
0000-0003-1298-2040
GL
Chen
Division of Gastroenterology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 441, Taiwan.
Wen-Hsiu
WH
Hsu