Acute Ischemic Colitis due to Oral Phenylephrine

El-Alali, Emran; Alhmoud, Tarik

doi:10.14309/crj.0000000000000459

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Ward et al, 2014 4 El-Alali et al, 2020 5 The present report In conclusion, IC is a serious drug-induced adverse event. Our case exemplifies that OTC phenylephrine use can cause IC in patients with no known risk factors.…”

Section: Authors Yrsupporting

confidence: 49%

“…Faisal Inayat, MBBS 1 Aamir Saeed, MD 2 Sobaan Taj, MD 3 Sidra Kulsoom, MD 4 Attiq Ur Rehman, MD 5 Muhammad Kashif Amin, MD 6 Zahra Akhtar, MD 1 Zaka Ul Haq, MD 7 1 Allama Iqbal Medical College, Lahore, Pakistan 2 Merit Health Wesley, Hattiesburg, MS 3 Jersey Shore University Medical Center, Neptune, NJ 4 Conemaugh Memorial Medical Center, Johnstown, PA 5 Mercy Medical Center, Baltimore, MD 6 University of Kansas Medical Center, Kansas City, KS 7 Raritan Bay Medical Center, Perth Amboy, NJ Presented as an abstract at the Annual Scientific Meeting of the American College of Gastroenterology, 24-27 October 2021, in Las Vegas, NV.…”

Section: Authors Yrmentioning

confidence: 99%

“…After removing redundant and duplicate results, our research yielded only 2 case reports (level of clinical evidence: IV). 4,5 A comparative analysis of phenylephrine-induced IC is presented (Table 1). Our search also showed that the likelihood of pseudoephedrine causing IC was higher than that of phenylephrine.…”

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confidence: 99%

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Acute Ischemic Colitis Associated With Oral Phenylephrine Use: A Rare Adverse Effect of a Common Over-the-Counter Drug

Inayat

Saeed²,

Taj

et al. 2023

American Journal of Therapeutics

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Section: Authors Yrsupporting

confidence: 49%

Section: Authors Yrmentioning

confidence: 99%

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Acute Ischemic Colitis Associated With Oral Phenylephrine Use: A Rare Adverse Effect of a Common Over-the-Counter Drug

Inayat

Saeed²,

Taj

et al. 2023

American Journal of Therapeutics

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“…One can reasonably assume that the extension of PDE's half-life - even at normal therapeutic doses - would cause regional vasoconstriction and an increase in intracranial blood pressure. Indeed, several accidental overdoses of PDE have been described, with a hypertensive crisis, coronary vasospasm, acute myocardial infarction, or acute ischemic colitis ( 10 , 11 ). Only one report mention an association between PDE administration and PRES ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome After Self-Medication With an Oral Decongestant: A Case Report

et al. 2022

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IntroductionPosterior reversible encephalopathy syndrome (PRES) is a rare neurological disorder caused by the dysregulation of cerebral perfusion.Case PresentationWe report on a 18-year-old female patient with a history of end-stage renal disease and thrice weekly hemodialysis. She was admitted to the emergency department with mental confusion, blurred vision, headaches, and vomiting, following self-medication with an oral decongestant containing pseudoephedrine. We observed hypointense lesions with T1-weighted MRI and hyperintense areas with T2-weighted and fluid-attenuated inversion recovery MRI sequences. The lack of diffusion restriction was consistent with a diagnosis of PRES. A concomitant Enterobacter cloacae hemodialysis catheter-bloodstream infection was also diagnosed. We hypothesize that both sepsis and inappropriate self-medication with oral pseudoephedrine contributed to hypertension, endothelial dysfunction, and vasogenic edema. The patient received intensive care and made a full recovery.DiscussionPRES is a life-threatening condition that requires intensive care. Identification of the etiology is the keystone of medical care. Inappropriate self-medication with an oral decongestant might trigger PRES - highlighting the importance of patient education.

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“…A total of 18 case reports (clinical evidence level: IV) of acute IC were identified in association with the use of pseudoephedrine and phenylephrine [9][10][11][12][13][14][15][16][17][18][19][20][21]…”

Section: Patients Demographicsmentioning

confidence: 99%

Acute ischemic colitis associated with oral decongestant use: a systematic review

2023

J Clin Transl Res

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Background and Aim: Acute ischemic colitis (IC) has been linked with the use of oral decongestants. However, clinical evidence on this association remains limited. We aim to evaluate the occurrence and clinical outcomes of acute IC following over-the-counter (OTC) use of pseudoephedrine and phenylephrine. Methods: We conducted a systematic review of the MEDLINE, Google Scholar, Scopus, and Embase databases between inception and July 20, 2022. Specific search terms were used. The inclusion criteria consisted of English-language articles describing acute IC secondary to pseudoephedrine or phenylephrine. Results: A total of 18 case reports (level of clinical evidence: IV) fulfilled our inclusion criteria. The mean age of patients was 51.6 ± 15.3 years, with 14 (77.8%) cases reported in women. The clinical presentation was mainly related to abdominal pain 16 (88.9%), hematochezia 15 (83.3%), and/or abdominal tenderness 10 (55.6%). The medical background showed that 5 (27.8%) patients were previously healthy. In the 13 (72.2%) patients with comorbidities, hypertension 6 (46.2%), a history of tobacco use 5 (38.5%), and psychiatric illnesses 4 (30.8%) were commonly reported. Leukocytosis was encountered in 13 (72.2%) patients. Diagnostic investigations included a combination of computed tomography scan and colonoscopy in 10 (55.6%), colonoscopy alone in 6 (33.3%), and flexible sigmoidoscopy in 1 (5.6%) patient. Colonoscopic biopsy was the mainstay of diagnosis in 15 (83.3%) patients. Treatment was based on supportive care in 18 (100%), concurrent antibiotic use in 2 (11.1%), and surgical intervention in 1 (5.6%) patient. Recurrent episodes of IC occurred in 4 (22.2%) patients. Conclusions: Acute IC secondary to oral decongestants remains a rare but important clinical phenomenon. Clinical suspicion and imaging findings are important for the early diagnosis. Relevance to Patients: In unexplained cases of IC, clinicians should specifically inquire about oral decongestants since they are OTC and patients commonly fail to reveal their usage. These drugs should be avoided for transient cold symptoms, especially in women.

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Acute Ischemic Colitis due to Oral Phenylephrine

Cited by 5 publications

References 15 publications

Acute Ischemic Colitis Associated With Oral Phenylephrine Use: A Rare Adverse Effect of a Common Over-the-Counter Drug

Acute Ischemic Colitis Associated With Oral Phenylephrine Use: A Rare Adverse Effect of a Common Over-the-Counter Drug

Posterior Reversible Encephalopathy Syndrome After Self-Medication With an Oral Decongestant: A Case Report

Acute ischemic colitis associated with oral decongestant use: a systematic review

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