Journal of the Japanese Society of Intensive Care Medicine
Online ISSN : 1882-966X
Print ISSN : 1340-7988
ISSN-L : 1340-7988
A case of cholinergic crisis caused by distigmine bromide administered for paralytic ileus
Toshihiro SakuraiShu YamadaMaki KitadaSatoshi HashimotoShoko HashimotoFumihiko KimuraMasahiro HaradaTakeshi Takahashi
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2014 Volume 21 Issue 6 Pages 635-638


Distigmine bromide, an anticholinesterase, is available for the treatment of strangury. Because this drug was reported to cause cholinergic crisis as a severe side effect, the clinical dose has been limited. However, cases of cholinergic crisis are still reported. We experienced a case of shock caused by severe pneumonia and paralytic ileus. Initially, the condition was considered as septic shock. However, it was later, diagnosed as cholinergic crisis because the patient took distigmine bromide and the serum cholinesterase level decreased significantly. Because most of the drug is excreted in the feces, drug concentration in the blood increases when gastrointestinal peristalsis decreases, which is observed in conditions such as paralytic ileus, we must be aware that cholinergic crisis may occur in patients with paralytic ileus.

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© 2014 The Japanese Society of Intensive Care Medicine
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