Use of neostigmine for acute colonic pseudo-obstruction in a patient receiving dexmedetomidine

Dodds, Michelle M., Frazer, Callum D., Lipman, Jeffrey and Reade, Michael (2016) Use of neostigmine for acute colonic pseudo-obstruction in a patient receiving dexmedetomidine. Critical Care and Resuscitation, 18 1: 59-61.

Author Dodds, Michelle M.
Frazer, Callum D.
Lipman, Jeffrey
Reade, Michael
Title Use of neostigmine for acute colonic pseudo-obstruction in a patient receiving dexmedetomidine
Journal name Critical Care and Resuscitation   Check publisher's open access policy
ISSN 1441-2772
Publication date 2016-03
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 18
Issue 1
Start page 59
End page 61
Total pages 3
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Collection year 2017
Language eng
Abstract Acute colonic pseudo-obstruction is commonly encountered in intensive care, and its treatment may include neostigmine. Invasively ventilated patients are increasingly receiving dexmedetomidine as a combination sedative–analgesic. Bradycardia is a recognised, but rarely problematic, adverse effect of both medications. We are unaware of published reports of patients who have received these medications in combination, and we report such a case. A 64-year-old man was sedated with dexmedetomidine, which may have contributed to his development of acute colonic pseudoobstruction. After he was started on neostigmine, profound bradycardia (heart rate of 25 beats per minute [bpm]) ensued, which resolved rapidly after administration of a single bolus of intravenous atropine. We suggest avoiding this combination of drugs in critically ill patients.
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Institutional Status UQ

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Sub-type: Article (original research)
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