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Drug ineffectiveness: case report A 35-year-old woman exhibited drug ineffectiveness during treatment with dinoprost and oxytocin for massive atonic haemorrhage in post-partum period. The primigravida woman was diagnosed with chronic idiopathic intestinal pseudo-obstruction (CIIP) at the age of 4 years. She had received parenteral nutrition since the age of 17 years with intermittent decompression via gastric tube. She was diagnosed with essential hypertension at the age of 34 years and started receiving amlodipine 20 mg/day. Subsequently, she became pregnant, and her amlodipine was discontinued. At gestational weeks 19, an ultrasound revealed an enlarged fetal bladder and stomach without intestinal dilatation, renal pelvis dilatation or key-hole sign. The amniotic fluid pocket was 6.5cm. At gestational weeks 30, a repeat ultrasound revealed a megacystis occupying entire fetal abdominal cavity, appropriate fetal growth and no urinary tract obstruction. At gestational weeks 32, her BP increased to 140/90mm Hg, which was maintained in the normal range with methyldopa 250 mg/day. At gestational weeks 33 and 2 days, she was admitted due to catheter-related infection. On admission, she was diagnosed with superimposed pre-eclampsia. Therefore, her methyldopa was switched to nicardipine 0.2 µg/kg/min, and unspecified IV antibacterials [antibiotics] were added to her treatment regimen. Subsequently, her infection rapidly improved and BP decreased to