The Use of Intravenous Neostigmine in Palliation of Severe Ileus
Neostigmine is a parasympathomimetic drug that acts as a reversible acetylcholinesterase inhibitor. Clinically it is used in patients with acute colonic pseudo-obstruction (ACPO or Ogilvie’s syndrome, which is a gastrointestinal motility disorder characterized by marked dilatation of the colon in th...
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Wiley
2013-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/796739 |
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| author | Pashtoon Murtaza Kasi |
| author_facet | Pashtoon Murtaza Kasi |
| author_sort | Pashtoon Murtaza Kasi |
| collection | DOAJ |
| description | Neostigmine is a parasympathomimetic drug that acts as a reversible acetylcholinesterase inhibitor. Clinically it is used in patients with acute colonic pseudo-obstruction (ACPO or Ogilvie’s syndrome, which is a gastrointestinal motility disorder characterized by marked dilatation of the colon in the absence of mechanical obstruction), postoperative ileus, urinary retention, myasthenia gravis, and in anesthesia to reverse the effects of nondepolarizing muscle relaxants. Both bolus and infusion are noted to be effective and lead to prompt evacuation of flatus or stool with a reduction in abdominal distention on physical examination. Median duration is noted to be 4–30 minutes in some trials. Here we present our experience of using 2 mg of intravenous neostigmine to help relieve the severe abdominal distention and ileus in a patient with severe fecal impaction when all conservative measures had been futile. The most frequent side effect of the drug is abdominal pain/cramping, which was noted in our patient as well. Other complications include bradycardia which is very infrequently symptomatic to require atropine. Overall, the drug is a simple, safe, and effective strategy; and as pointed out in the previous studies, the drug appears to be underused in patients who do not have a true contraindication to its use. |
| format | Article |
| id | doaj-art-33b97c7d071a4cf384e6c6654a3dd3ba |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-33b97c7d071a4cf384e6c6654a3dd3ba2025-02-03T01:22:18ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362013-01-01201310.1155/2013/796739796739The Use of Intravenous Neostigmine in Palliation of Severe IleusPashtoon Murtaza Kasi0International Scholars Program, Department of Internal Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA 15213, USANeostigmine is a parasympathomimetic drug that acts as a reversible acetylcholinesterase inhibitor. Clinically it is used in patients with acute colonic pseudo-obstruction (ACPO or Ogilvie’s syndrome, which is a gastrointestinal motility disorder characterized by marked dilatation of the colon in the absence of mechanical obstruction), postoperative ileus, urinary retention, myasthenia gravis, and in anesthesia to reverse the effects of nondepolarizing muscle relaxants. Both bolus and infusion are noted to be effective and lead to prompt evacuation of flatus or stool with a reduction in abdominal distention on physical examination. Median duration is noted to be 4–30 minutes in some trials. Here we present our experience of using 2 mg of intravenous neostigmine to help relieve the severe abdominal distention and ileus in a patient with severe fecal impaction when all conservative measures had been futile. The most frequent side effect of the drug is abdominal pain/cramping, which was noted in our patient as well. Other complications include bradycardia which is very infrequently symptomatic to require atropine. Overall, the drug is a simple, safe, and effective strategy; and as pointed out in the previous studies, the drug appears to be underused in patients who do not have a true contraindication to its use.http://dx.doi.org/10.1155/2013/796739 |
| spellingShingle | Pashtoon Murtaza Kasi The Use of Intravenous Neostigmine in Palliation of Severe Ileus Case Reports in Gastrointestinal Medicine |
| title | The Use of Intravenous Neostigmine in Palliation of Severe Ileus |
| title_full | The Use of Intravenous Neostigmine in Palliation of Severe Ileus |
| title_fullStr | The Use of Intravenous Neostigmine in Palliation of Severe Ileus |
| title_full_unstemmed | The Use of Intravenous Neostigmine in Palliation of Severe Ileus |
| title_short | The Use of Intravenous Neostigmine in Palliation of Severe Ileus |
| title_sort | use of intravenous neostigmine in palliation of severe ileus |
| url | http://dx.doi.org/10.1155/2013/796739 |
| work_keys_str_mv | AT pashtoonmurtazakasi theuseofintravenousneostigmineinpalliationofsevereileus AT pashtoonmurtazakasi useofintravenousneostigmineinpalliationofsevereileus |