Thursday, January 17, 2008

Thursday January 17, 2008
Oglivie's syndrome

Q: Which electrolyte abnormality may prevent Neostigmine from resolving Oglivie's syndrome (Acute colonic pseudo-obstruction)?

A; Potassium

Acute colonic pseudo-obstruction or Ogilvie syndrome, is an acute large bowel obstruction with no evidence of mechanical colonic obstruction. It is said to be due to invasion and destruction of the splanchnic nerves, superior mesenteric ganglion, and celiac nerve plexus.Neostigmine, an acetylcholinesterase inhibitor, increases acetylcholine concentrations at the enteric nervous system neuromuscular junctions, enabling smooth muscle to contract. Neostigmine is given as intravenous, 2 mg over 5 minutes. A repeat dosage may be given if necessary. Side effects of neostigmine include sweating, salivation, bradycardia, hypotension, and bronchospasm. Due to possible bradycardia, atropine should be available at bedside. The neostigmine is eliminated by kidney and should be use with caution in renal failure.An anecdotal report indicates that patients with hypokalemia, may not respond to neostigmine. 1

References: click to get article

Acute colonic pseudo-obstruction (Ogilvie's syndrome) in critical care unit - Year : 2004, Volume : 8, Issue : 1, Page : 43-45

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