Ipratropium bromide

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Ipratropium bromide Unilateral mydriasis: case report A 67-year-old woman developed unilateral mydriasis during treatment with ipratropium bromide for suspected infectious exacerbation of chronic obstructive pulmonary disease (COPD). The woman, who had a history of COPD, presented with purulence of sputum and dyspnoea upon moderate efforts. Due to suspected infectious COPD exacerbation, she was treated with ipratropium bromide along with levofloxacin through a nebulised face-mask [dosage not stated]. Three days following the treatment, she presented with vision difficulties in the the right eye in very bright environments. Additionally, an asymmetry of the pupil size was observed. A physical examination revealed anisocoria and non-reactive mydriasis of the right pupil in a well-lit environment. Her neurological examination was normal. The presence of Adie syndrome was ruled due to negative pilocarpine test. Based on all these symptoms and findings, she was diagnosed with unilateral mydriasis secondary to ipratropium bromide The woman’s therapy with ipratropium bromide was withdrawn. She recovered within 24 hours after the cessation of ipratropium bromide. Author comment: Faced with the diagnosis of pharmacological mydriasis, treatment with ipratropium bromide was withdrawn with resolution of the condition after 24 hours. According to its summary of product characteristcs mydriasis due to ipratropium bromide is a rare adverse effect. Martin Guerra JM, et al. Unilateral mydriasis of pharmacological origin. Revista Espanola de Geriatria y Gerontologia 54: 360, No. 6, Nov-Dec 2019. Available from: URL: http://doi.org/10.1016/j.regg.2018.11.009 [Spanish; summarised from a 803441411 translation] - Spain

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Reactions 21 Dec 2019 No. 1784