Nearly Fatal Hydroxychloroquine Overdose Successfully Treated with Midazolam, Propofol, Sodium Bicarbonate, Norepinephrine, and Intravenous Lipid Emulsion.
Journal
Case reports in emergency medicine
ISSN: 2090-648X
Titre abrégé: Case Rep Emerg Med
Pays: United States
ID NLM: 101591814
Informations de publication
Date de publication:
2021
2021
Historique:
received:
01
08
2020
revised:
31
03
2021
accepted:
03
04
2021
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
epublish
Résumé
In the context of the current COVID-19 pandemic, there has been renewed interest in the drug hydroxychloroquine. However, clinicians should be aware of the dangers of hydroxychloroquine intoxication, an insufficiently studied condition. Since high-quality scientific evidence is lacking, treatment options are based on experience in chloroquine toxicity. Activated charcoal is advised if the patient presents early. Sedation with diazepam, early ventilation, and continuous epinephrine infusion are considered effective in treating severe intoxication. Caution is advised when substituting potassium. Despite the lack of formal evidence, sodium bicarbonate appears to be useful and safe in case of QRS widening. Intravenous lipid emulsion, with or without hemodialysis, remains controversial but appears to be safe. As a last resort, extracorporeal life support might be considered in case of persisting hemodynamic instability.
Sections du résumé
BACKGROUND
BACKGROUND
In the context of the current COVID-19 pandemic, there has been renewed interest in the drug hydroxychloroquine. However, clinicians should be aware of the dangers of hydroxychloroquine intoxication, an insufficiently studied condition.
CONCLUSION
CONCLUSIONS
Since high-quality scientific evidence is lacking, treatment options are based on experience in chloroquine toxicity. Activated charcoal is advised if the patient presents early. Sedation with diazepam, early ventilation, and continuous epinephrine infusion are considered effective in treating severe intoxication. Caution is advised when substituting potassium. Despite the lack of formal evidence, sodium bicarbonate appears to be useful and safe in case of QRS widening. Intravenous lipid emulsion, with or without hemodialysis, remains controversial but appears to be safe. As a last resort, extracorporeal life support might be considered in case of persisting hemodynamic instability.
Identifiants
pubmed: 33968450
doi: 10.1155/2021/8876256
pmc: PMC8081608
doi:
Types de publication
Case Reports
Langues
eng
Pagination
8876256Informations de copyright
Copyright © 2021 Goswin Onsia and Sarah Bots.
Déclaration de conflit d'intérêts
GO and SB declare that they have no competing interests.
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