0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Confusion From Pyridostigmine Bromide: Was There Bromide Intoxication?-Reply

David M. Rothenberg, MD; Robert Barkin, PharmD; Russell H. Glantz, MD; Arnold S. Berns, MD
JAMA. 1990;264(4):455. doi:10.1001/jama.1990.03450040042024.
Text Size: A A A
Published online

ABSTRACT

In Reply.—  Drs Senecal and Osterloh raise concerns regarding the clinical correlation and the diagnosis of bromide intoxication in our patient. However, we still consider this diagnosis valid. As pointed out in our article, we also believe that this level of bromide is what would be considered by most to be below a toxic level. Although symptoms are not "usually" seen at this level, we believe that the temporal relationship of symptoms, as well as the peak negative anion gap, correlates with the high dose of pyridostigmine bromide and the bromide level measured. The normal half-life of bromide may have been easily reduced with the use of intravenous crystalloid solution, as was noted in our report, and this may have contributed to the rapid resolution of symptoms.Drs Senecal and Osterloh also question whether an oral dose of 1 mg of levorphanol tartrate could have influenced the encephalopathic picture in

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();