What is known and objective: Post-operative gastrointestinal ileus is a common complication that can cause erratic absorption of oral pharmaceuticals.
Case summary: This is a case of near-fatal, antihypertensive medication overdose due to gastric ileus in a 40-year-old patient following combined kidney-pancreas transplant. After being transitioned from intravenous to oral antihypertensive medications, the patient sustained pulseless bradycardia requiring resuscitative measures. Suspicion of accumulated medication bolus due to gastric ileus was confirmed by supratherapeutic serum labetalol measurement of 493 ng/mL (therapeutic range: 30-180 ng/mL).
What is new and conclusion: Judicious use of oral pharmaceuticals, particularly those with relatively narrow therapeutic ranges, is warranted in patients with post-operative ileus.
Keywords: absorption; adverse event; blood level; clinical pharmacokinetics; drug absorption; hypertension; ileus; overdose; renal transplantation; β-blocker.
© 2014 John Wiley & Sons Ltd.