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Tiotropium Bromide/Olodaterol Related Acute Cognitive Impairments

Case Reports in Clinical Medicine 2023年第5期12卷 119-125页

作者： Samer Alkhuja monika girgis Department of Medicine The Commonwealth Medical College Lehigh Valley Health Network-Pocono Stroudsburg PA USA

Background: The use of anticholinergics has been on the rise. With the increase in population longevity, more medication-related cognitive impairments (ACIs) have been reported. These impairments result in significant morbidities. We present a case that stresses on the importance of being vigilant when prescribing anticholinergic medications, especially in the elderlies. Case Report: A case of ACIs related to the use of tiotropium bromide/olodaterol (Stiolto Respimat) is being reported in a 71-year-old white man with COPD. Treatment with budesonide 180 mcg/actuation, and tiotropium bromide/olodaterol (Stiolto Respimat) inhalers was initiated. Two days after initiating treatment, the patient developed ACIs which manifested by gait imbalance, short-term memory dysfunction, inability to remember his family members, or to take his medications. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued. After three days, a full recovery of ACIs was reported. A month later, due to worsening dyspnea, the patient self-resumed the medicine. Similar ACIs were reported within two days of resuming treatment. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued indefinitely. Full recovery of ACIs was reported. Conclusion: ACIs should be noted as a significant side effect of tiotropium bromide/olodaterol. Clinicians should be vigilant, when prescribing anticholinergic medications to elderlies.

关键词： Cognitive Impairment Stiolto Tiotropium Bromide/Olodaterol COPD

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Somnambulism: Varenicline-Induced Sleep Driving

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Case Reports in Clinical Medicine 2023年第7期12卷 213-217页

作者： Samer Alkhuja monika girgis Mohammad Ali Pravinkumar Patel Olutunde Odeyemi Department of Medicine The Commonwealth Medical College Lehigh Valley Health Network-Pocon Stroudsburg Pennsylvania USA

Background: Varenicline, which is derived from the cytisine compound, is used to assess in smoking cessation. Sleep driving (SD) is often classified as a variant of somnambulism. Although, somnambulism has been reported as a side effect of varenicline, varenicline-induced sleep driving (VISD) has not been reported. Case Report: A 56-year-old man with a history of 35 pack year smoking who presented for smoking cessation counseling. Treatment with varenicline was initiated. In the following night, the patient drove to a shopping center and woke up in his car. Varenicline was discontinued. SD has not been reported in the following nights. In a repeated attempt to stop smoking, treatment with varenicline was resumed by the patient. SD reoccurred in the following night. Varenicline was discontinued indefinitely, and SD has not been reported.

关键词： Varenicline Sleep Walking Arousal Parasomnia

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