Unilateral Pharmacologic Mydriasis in a Patient With Respiratory Compromise

Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

“…[7] If ipratropium bromide (a quaternary anticholinergic agent that produces bronchodilation in asthmatic patients slower than beta 2 inhaled agents) is administered blocking the cholinergic stimulation of sphincter muscle, the constriction does not occur. [89] In our case, the recuperation of the normal pupil diameter after the suspension of ipratropium excludes the role of the other medication able to cause unilateral mydriasis (salbutamol). Nevertheless, the long duration of the episode (48 h) could be explained with the possible interaction between beta-adrenergic agonists and muscarinic antagonists in iris sphincter relaxation, as seen in vitro in previous reports.…”

Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

“…[7] If ipratropium bromide (a quaternary anticholinergic agent that produces bronchodilation in asthmatic patients slower than beta 2 inhaled agents) is administered blocking the cholinergic stimulation of sphincter muscle, the constriction does not occur. [89] In our case, the recuperation of the normal pupil diameter after the suspension of ipratropium excludes the role of the other medication able to cause unilateral mydriasis (salbutamol). Nevertheless, the long duration of the episode (48 h) could be explained with the possible interaction between beta-adrenergic agonists and muscarinic antagonists in iris sphincter relaxation, as seen in vitro in previous reports.…”

Unilateral pupillary mydriasis from nebulized ipratropium bromide: A false sign of brain herniation in the intensive care unit

“…Nebulized ipratropium bromide is one of the most commonly used medications in the ICU. It may cause unilateral mydriasis from topical administration or accidental spillage of ipratropium bromide aerosol or droplets into the eye from a poor-fitting mask[12345] or broken nebulizer circuit. [6] The dose of the medication and the frequency of administration may also play a role in inducing mydriasis.…”

Transient Anisocoria During Wheezy Infant Treatment due to Ipratropium-Bromide

“…Anisocoria or unequal pupil size is an alarming physical sign, leading most of the time to an extensive and expensive neuroradiologic investigation to rule out life-threatening conditions such as cerebral tumor, expanding aneurysm or intracranial bleeding (1,2). Some pharmacological agents can cause anisocoria.…”

Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

“…[7] If ipratropium bromide (a quaternary anticholinergic agent that produces bronchodilation in asthmatic patients slower than beta 2 inhaled agents) is administered blocking the cholinergic stimulation of sphincter muscle, the constriction does not occur. [89] In our case, the recuperation of the normal pupil diameter after the suspension of ipratropium excludes the role of the other medication able to cause unilateral mydriasis (salbutamol). Nevertheless, the long duration of the episode (48 h) could be explained with the possible interaction between beta-adrenergic agonists and muscarinic antagonists in iris sphincter relaxation, as seen in vitro in previous reports.…”

Unilateral pupillary mydriasis from nebulized ipratropium bromide: A false sign of brain herniation in the intensive care unit

“…Nebulized ipratropium bromide is one of the most commonly used medications in the ICU. It may cause unilateral mydriasis from topical administration or accidental spillage of ipratropium bromide aerosol or droplets into the eye from a poor-fitting mask[12345] or broken nebulizer circuit. [6] The dose of the medication and the frequency of administration may also play a role in inducing mydriasis.…”

Transient Anisocoria During Wheezy Infant Treatment due to Ipratropium-Bromide

“…Anisocoria or unequal pupil size is an alarming physical sign, leading most of the time to an extensive and expensive neuroradiologic investigation to rule out life-threatening conditions such as cerebral tumor, expanding aneurysm or intracranial bleeding (1,2). Some pharmacological agents can cause anisocoria.…”

Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

“…[7] If ipratropium bromide (a quaternary anticholinergic agent that produces bronchodilation in asthmatic patients slower than beta 2 inhaled agents) is administered blocking the cholinergic stimulation of sphincter muscle, the constriction does not occur. [89] In our case, the recuperation of the normal pupil diameter after the suspension of ipratropium excludes the role of the other medication able to cause unilateral mydriasis (salbutamol). Nevertheless, the long duration of the episode (48 h) could be explained with the possible interaction between beta-adrenergic agonists and muscarinic antagonists in iris sphincter relaxation, as seen in vitro in previous reports.…”

Unilateral pupillary mydriasis from nebulized ipratropium bromide: A false sign of brain herniation in the intensive care unit

“…Nebulized ipratropium bromide is one of the most commonly used medications in the ICU. It may cause unilateral mydriasis from topical administration or accidental spillage of ipratropium bromide aerosol or droplets into the eye from a poor-fitting mask[12345] or broken nebulizer circuit. [6] The dose of the medication and the frequency of administration may also play a role in inducing mydriasis.…”

Transient Anisocoria During Wheezy Infant Treatment due to Ipratropium-Bromide

“…Anisocoria or unequal pupil size is an alarming physical sign, leading most of the time to an extensive and expensive neuroradiologic investigation to rule out life-threatening conditions such as cerebral tumor, expanding aneurysm or intracranial bleeding (1,2). Some pharmacological agents can cause anisocoria.…”