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A Case of Acute Distigmine Bromide Intoxication in the Therapeutic Dosage for Treatment of Underactive Neurogenic Bladder Masayoshi Tada 1,2 , Nobuya Fujita 1,2 , Maiko Umeda 1,2 , Hiroshi Koike 3 , Hiroko Nagai 1,2 1Department of Neurology, Nagaoka Red Cross Hospital 3Department of Urology, Nagaoka Red Cross Hospital Keyword: distigmine bromide intoxication , cholinergic crisis , cholinesterase inhibitor , underactive neurogenic bladder pp.415-419
Published Date 2004/5/1
DOI https://doi.org/10.11477/mf.1406100283
  • Abstract
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 Distigmine bromide(Ubretid(R)) is a long-acting anticholinesterase, widely used for the treatment of underactive neurogenic bladder and myasthenia gravis. Our study concerns a 73-year-old man treated with a potentially life-threatening cholinergic state due to distigmine bromide. He had been administered distigmine bromide orally for over two years at a daily dosage of 10mg as a treatment for underactive neurogenic bladder. He suddenly developed diarrhea and consciousness disturbance during treatment of his urinary tract infection. Bradycardia and miosis were noted. Blood examination revealed extremely low levels of the plasma cholinesterase activity. The condition was diagnosed as distigmine bromide intoxication. All cholinergic symptoms disappeared in several days after the administration of distigmine bromide was terminated. Cholinergic crisis due to overdosage with anticholinesterases is well known, and the myasthenic patients are usually supervised in the early stages of dosage regulation to guard against the possibility of cholinergic crisis. However the use of oral distigmine bromide, even in therapeutic doses for urinary retention, could result in cholinergic crisis. We therefore conclude that extreme caution must be used in administering distigmine bromide.

(Received : November 6, 2003)


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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