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Prodromal Symptoms of Cholinergic Crisis Following Appropriate Administration of Rivastigmine Patch
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JPY
Abstract
Rivastigmine is a cholinesterase inhibitor used in the treatment of Alzheimer‒type dementia. Since rivastigmine patch is a transdermal patch, the incidence of gastrointestinal disorders is lower than that associated with oral administration. Some case reports have reported cholinergic symptoms following the administration of rivastigmine patch, but the administration of rivastigmine patch was inappropriate in these reports. Nowadays, cholinergic symptoms following the appropriate administration of rivastigmine patch are rarely reported. We present a case with prodromal symptoms of cholinergic crisis following appropriate administration of rivastigmine patch. A 67‒year‒old woman with Alzheimer‒type dementia receiving 13.5 mg of rivastigmine patch presented with prodromal symptoms of cholinergic crisis such as nausea, vomiting, and diarrhea with low serum cholinesterase. Rivastigmine patch was removed immediately, and her gastrointestinal disorders were resolved in a day. This case suggests that careful attention to the appearance of prodromal symptoms of cholinergic crisis is important and serum cholinesterase should be checked even in case of appropriate administration of rivastigmine patch.
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