Karin Lust, MBBS; Iain Livingstone, MBBS
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Lust K, Livingstone I. Nebulizer-Induced Anisocoria. Ann Intern Med. 1998;128:327. doi: 10.7326/0003-4819-128-4-199802150-00041
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Published: Ann Intern Med. 1998;128(4):327.
TO THE EDITOR:
A 29-year-old woman, gravid III, para II, at 20 weeks' gestation was admitted to an obstetric hospital with shortness of breath. A medical resident was asked to review the case because the patient reported headache and blurred vision and had a dilated right pupil. Prompt review revealed normal vital signs with no meningismus. Respiratory, cardiovascular, and abdominal examinations were unremarkable. Central nervous system examination revealed that the right pupil was fixed and dilated, a finding unassociated with any other neurologic sign. The patient said she had not ingested any medications or used topical ophthalmic drops. On further review of the patient's medications, it was noted that she had been receiving salbutamol (1 mL, 5 mg/mL) and ipratropium bromide (1 mL, 250 µg/mL), combined in a nebulizer, every 6 hours. The patient was given paracetamol for the headache, and her right eye was patched. She continued to take nebulized salbutamol and ipratropium bromide. The following day, the eye was examined and found to be completely normal.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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