Q: 54 year old male is brought  to ICU with acute alcohol intoxication. Intravenous thiamine is  quickly administrated to patient prior to dextrose, but patient went into impending respiratory failure with severe audible wheezing. Your diagnosis?


Answer: Bronchospasm from Thiamine administration.

Thiamine is usually a very safe medicine but can have a rare occurrence of anaphylaxis and bronchospasm. Though, it may be more of an academic interest but astute clinician should always keep in mind the possible adverse effects even of usually safe drugs.



Reference: 

Cook, C. C. H., Hallwood, P. M. and Thomson, A. D. (1998) B vitamin deficiency and neuropsychiatric syndromes in alcohol misuse. Alcohol and Alcoholism 33, 317–336.