Abstract
A cholinergic crisis is a condition characterized by nausea, vomiting, hypotension, bradycardia, diarrhea, diaphoresis,miosis, and salivation caused by acetylcholine receptor overstimulation. Bethanechol-induced cholinergic crisis has been rarely reported. Decreased cholinesterase activity cannot be utilized as a diagnostic criterion, unlike cholinesterase inhibitor-induced cholinergic crisis, and a clinical diagnosis of parasympathetic overactivity is crucial.
A 79-year-old male patient with diabetic neuropathy complicated by a urinary tract infection developed a cholinergic crisis following a glycerin enema procedure. He experienced vomiting, hypotension, bradycardia, and increased airway secretions. These symptoms persisted for 6 h and were self-limited. Patient factors, such as constipation, renal insufficiency, diabetic autonomic neuropathy, and complicating infection, in addition to bethanechol administration and a glycerin enema procedure, were considered contributing factors to the stimulation of his parasympathetic
nerve, which caused the development of the cholinergic crisis.
