R. BRIAN SMITH, M.D., F.A.C.P.; PETER M. WATERMAN, M.D.
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To the editor: Recently Fratto (Ann Intern Med 88:362, 1978) reported a case of refractory bronchospasm believed to be activated via the muscarinic action resulting from the use of phospholine iodide eye drops. Therapy with methylxanthine bronchodilators, beta adrenergic agonists, and steroids resulted in no improvement. After 1 week the eye drops were changed and the bronchospasm improved.
In retrospect perhaps one significant therapeutic agent was omitted. Atropine sulfate is used frequently by anesthesiologists to block the muscarinic effects seen with drugs used to reverse nondepolarizing muscle relaxants. Rosen (1) considers the danger of giving atropine to patients with glaucoma
SMITH RB, WATERMAN PM. Therapy of Bronchospasm from Muscarinic Drugs. Ann Intern Med. ;89:289–290. doi: 10.7326/0003-4819-89-2-289_3
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Published: Ann Intern Med. 1978;89(2):289-290.
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