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Cardiovascular Toxicity Due to Otilonium Bromide Overdose: A Case Report
Syed Ahmed Zaki1, Mohamed Elmohamedy Helal1, Asrar Rashid1
1Paediatric Intensive Care Unit, NMC Royal Hospital, Abu Dhabi, United Arab Emirates.
The Journal of Emergency Medicine
|January 15, 2022
Summary
Otilonium bromide overdose can cause hypotension, challenging the assumption of its safety. This case highlights the need for emergency physician awareness regarding potential toxic effects of this widely used medication.
Area of Science:
- Pharmacology
- Toxicology
- Gastroenterology
Background:
- Otilonium bromide, a quaternary ammonium compound, is frequently prescribed for irritable bowel syndrome.
- It is generally considered safe due to poor systemic absorption and local action.
- No human overdose cases were previously documented, suggesting a low risk profile.
Observation:
- A 16-year-old female ingested 1000 mg (25 tablets of 40 mg) of otilonium bromide over 4 hours.
- The patient presented with severe systemic hypotension (76/40 mm Hg).
Findings:
- The patient's hypotension resolved after treatment with normal saline and calcium gluconate.
- This case demonstrates that otilonium bromide overdose can lead to significant hemodynamic compromise.
Implications:
- Emergency physicians should be aware of potential otilonium bromide toxicity, despite its perceived safety.
- Increased awareness is crucial as the use of otilonium bromide for irritable bowel syndrome and other conditions grows.
- This case report challenges the assumption that otilonium bromide overdose is without specific human health risks.
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