1. Too many pills to swallow: A case of a mixed overdose
- Author
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Andrew Jacques, Jonathan Sunkersing, and Louise Emily Hopkins
- Subjects
0301 basic medicine ,Olanzapine ,business.industry ,030111 toxicology ,Antagonist ,Propranolol ,Case Reports ,Critical Care and Intensive Care Medicine ,Critical Care Nursing ,Drug overdose ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Anesthesia ,Pill ,Medicine ,030212 general & internal medicine ,Amlodipine ,business ,medicine.drug - Abstract
Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity – profound hypotension and circulatory collapse, respiratory depression and coma. The patient had conventional therapy but failed to respond to this and was therefore commenced on IntraLipid infusion, high-dose insulin infusion and inotrope infusion. An endoscopy was performed in intensive care which revealed a large drug beozar – this was removed. We believe that this combination of infusions with early endoscopy could be beneficial in treating similar patients in the future and present the first case of a propranolol drug bezoar.
- Published
- 2017