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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Paralytic Ileus Possibly Associated with Nebulized Ipratropium Bromide
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Paralytic Ileus Possibly Associated with Nebulized Ipratropium Bromide

机译：麻痹性肠梗阻可能与溴化异丙托溴铵雾化有关

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Objective: To report a case of paralytic ileus possibly associated with nebulized ipratropium bromide.Case Summary: A 43-year-old man fell from a wall and was admitted to the intensive care unit (ICU) for the resulting thoracic trauma. An epidural thoracic catheter was placed for pain control using bupivacaine 0.25% and methadone 0.2 mg/mL. On hospital day 4, he developed purulent bronchiole constriction, and treatment with nebulized mesna and ipratropium bromide was started. Six hours after the first nebulization, the patient developed abdominal pain and bowel distension. An abdominal X-ray showed intestinal gas retention and dilated loops of large bowel. Paralytic ileus was diagnosed. Nebulized ipratropium bromide treatment was stopped and, during the following 24 hours, the patient gradually improved.Discussion: Nebulized ipratropium bromide-induced paralytic ileus is an uncommon adverse event that may be of considerable clinical relevance. Nebulized ipratropium bromide is predominantly deposited in the oropharynx, but some amount of the drug may be swallowed with resultant systemic adverse effects. Ipratropium bromide is a nonselective muscarinic antagonist and may inhibit contraction of the gastrointestinal tract. Paralytic ileus could not be attributed to an electrolyte disturbance or abdominal injury. The patient's paralytic ileus resolved when nebulized ipratropium bromide was stopped. An objective causality assessment showed that the paralytic ileus was possibly associated with this drug.Conclusions: This case report indicates that ipratropium bromide should be considered capable of inducing paralytic ileus.
机译：目的：报告一例可能与雾化的异丙托溴铵雾化相关的麻痹性肠梗阻的病例。病例摘要：一名43岁的男子从墙壁上摔下，被送入重症监护病房（ICU）进行胸外伤。使用0.25％布比卡因和0.2 mg / mL美沙酮放置硬膜外胸导管以控制疼痛。在医院的第4天，他出现了化脓性细支气管狭窄，并开始使用雾化的斜突肌和异丙托溴铵治疗。第一次雾化后六小时，患者出现腹痛和肠胀。腹部X线检查显示肠内气体滞留和大肠扩张。诊断为麻痹性肠梗阻。停止雾化异丙托溴铵的雾化治疗，随后的24小时内患者逐渐好转。讨论：雾化异丙托溴铵诱发的麻痹性肠梗阻是一种罕见的不良事件，可能与临床有很大关系。雾化的异丙托溴铵主要沉积在口咽中，但可能会吞咽一定量的药物，从而导致全身性不良反应。异丙托溴铵是一种非选择性毒蕈碱拮抗剂，可能会抑制胃肠道收缩。麻痹性肠梗阻不能归因于电解质紊乱或腹部损伤。停用雾化的异丙托溴铵后，患者的麻痹性肠梗阻消失。客观因果关系评估表明该药物可能与麻痹性肠梗阻有关。结论：本病例报告表明应将异丙托溴铵视为能够诱发麻痹性肠梗阻的药物。

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