title: Near-fatal, antihypertensive medication overdose due to post-operative gastric ileus.
abstract: OBJECTIVE
  Post-operative gastrointestinal ileus is a common complication that can cause erratic absorption of oral pharmaceuticals.
  
  
  METHODS
  This is a case of near-fatal, antihypertensive medication overdose due to gastric ileus in a 40-year-old patient following combined kidney-pancreas transplant. After being transitioned from intravenous to oral antihypertensive medications, the patient sustained pulseless bradycardia requiring resuscitative measures. Suspicion of accumulated medication bolus due to gastric ileus was confirmed by supratherapeutic serum labetalol measurement of 493 ng/mL (therapeutic range: 30-180 ng/mL).
  
  
  CONCLUSIONS
  Judicious use of oral pharmaceuticals, particularly those with relatively narrow therapeutic ranges, is warranted in patients with post-operative ileus.
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Selden
authors.forename: S
authors.initials: S
authors.lastname: Shugarts
authors.forename: A
authors.initials: A
authors.lastname: Wu
authors.forename: D
authors.initials: D
authors.lastname: Lung
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced*; D062787:Drug Overdose; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D016035:Pancreas Transplantation / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents
keywords: absorption; adverse event; blood level; clinical pharmacokinetics; drug absorption; hypertension; ileus; overdose; renal transplantation; β-blocker