D G Menzies, A G Conn, I J Williamson, L F Prescott
{"title":"Fulminant hyperkalaemia and multiple complications following ibuprofen overdose.","authors":"D G Menzies, A G Conn, I J Williamson, L F Prescott","doi":"10.1007/BF03259927","DOIUrl":null,"url":null,"abstract":"<p><p>A previously healthy 17-year-old man was admitted in coma following major overdosage with ibuprofen and minor overdosage of doxepin (plasma concentrations 809 and 0.49 mg/L, respectively). Initially, potassium chloride (20 mmol 3-hourly) was infused because of mild hypokalaemia (K+ 2.8 mmol/L). 14 hours after admission the patient developed a hypermetabolic state with pyrexia, metabolic acidosis and progressive respiratory failure despite ventilation at 16 L/min, and a malignant broad complex tachycardia was associated with acute hyperkalaemia (K+ 8.3 mmol/L). The arrhythmia resolved with correction of the hyperkalaemia. Chest x-rays showed diffuse opacification throughout both lung fields and subsequently there was transient impairment of renal function, with evidence of mild rhabdomyolysis. Ventilatory support was required for 60 hours and a chest x-ray at 6 days showed extensive bilateral nodular shadowing, which was still present at follow-up 4 weeks later.</p>","PeriodicalId":77748,"journal":{"name":"Medical toxicology and adverse drug experience","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03259927","citationCount":"15","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical toxicology and adverse drug experience","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/BF03259927","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 15
Abstract
A previously healthy 17-year-old man was admitted in coma following major overdosage with ibuprofen and minor overdosage of doxepin (plasma concentrations 809 and 0.49 mg/L, respectively). Initially, potassium chloride (20 mmol 3-hourly) was infused because of mild hypokalaemia (K+ 2.8 mmol/L). 14 hours after admission the patient developed a hypermetabolic state with pyrexia, metabolic acidosis and progressive respiratory failure despite ventilation at 16 L/min, and a malignant broad complex tachycardia was associated with acute hyperkalaemia (K+ 8.3 mmol/L). The arrhythmia resolved with correction of the hyperkalaemia. Chest x-rays showed diffuse opacification throughout both lung fields and subsequently there was transient impairment of renal function, with evidence of mild rhabdomyolysis. Ventilatory support was required for 60 hours and a chest x-ray at 6 days showed extensive bilateral nodular shadowing, which was still present at follow-up 4 weeks later.