Pharmacobezoar Associated Prolonged Clinical Course in a Patient with Immediate Release Quetiapine Overdose.

Autor: Inoue F; Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima City, Hiroshima, 730-8518, Japan.; Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan., Okazaki Y; Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima City, Hiroshima, 730-8518, Japan. ur8nibhc1@gmail.com., Huh K; Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima City, Hiroshima, 730-8518, Japan., Ichiba T; Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima City, Hiroshima, 730-8518, Japan., Chiba T; Department of Emergency Medicine, International University of Health and Welfare, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan., Namera A; Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan.
Jazyk: angličtina
Zdroj: Journal of medical toxicology : official journal of the American College of Medical Toxicology [J Med Toxicol] 2024 Oct; Vol. 20 (4), pp. 430-433. Date of Electronic Publication: 2024 Aug 02.
DOI: 10.1007/s13181-024-01029-6
Abstrakt: Introduction: Quetiapine is available in both immediate-release (IR) and extended-release (XR) formulations. Quetiapine XR overdose is known to cause delayed increase in serum quetiapine concentrations. However, it is not certain whether quetiapine IR overdose would similarly cause a delayed increase in serum quetiapine concentrations.
Case Report: A 57-year-old woman with depression who was taking half a tablet of 25 mg quetiapine IR daily was transported to our emergency department with a complaint of disturbance of consciousness 12 h after a quetiapine IR overdose. On arrival, her initial vital signs were heart rate of 116 beats per minute, blood pressure of 77/43 mm Hg, and oxygen saturation of 91% under 10 L oxygen administration. Whole body plain computed tomography showed a large amount of gastric hyperdense content suggesting pharmacobezoar with a volume of 71.2 ml. After treatment with respiratory and circulatory support, gastric lavage was performed. Her disturbance of consciousness persisted until day 5, and she was extubated on day 7. The serum concentrations of quetiapine were 2690 ng/mL at 12 h after overdose, 5940 ng/mL at 40 h, and 350 ng/mL at 124 h after overdose. Serum concentrations of other co-ingestions were all below lethal levels.
Conclusion: A massive quetiapine IR overdose with pharmacobezoars can cause a delayed increase in serum quetiapine concentrations.
(© 2024. American College of Medical Toxicology.)
Databáze: MEDLINE
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