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Cardiovascular toxicity with levetiracetam overdose
- Publication Year :
- 2016
- Publisher :
- US : Taylor and Francis, 2016.
-
Abstract
- Objective: To describe the cardiovascular toxicity and pharmacokinetics of levetiracetam in overdose. Case Report: A 43-year-old female presented 8 h post ingestion of 60-80 g of levetiracetam with mild central nervous system depression, bradycardia, hypotension and oliguria. Her cardiovascular toxicity transiently responded to atropine and intravenous fluids. A bedside echocardiogram demonstrated normal left and right ventricular contractility. Despite her cardiovascular toxicity and oliguria, she had normal serial venous lactates and renal function; and made a complete recovery over 48 h. Her levetiracetam concentration was 463 mcg/ml 8 h post ingestion (therapeutic range 10-40 mcg/ml) and her concentration-time data best fitted a one-compartment model with first-order input and an elimination half-life of 10.4 h. Discussion: Levetiracetam in large ingestions appears to cause bradycardia and hypotension that is potentially responsive to atropine and intravenous fluids. Based on a normal echocardiogram, the mechanism for this effect may be levetiracetam acting at muscarinic receptors at high concentration. The pharmacokinetics of levetiracetam in overdose appeared to be similar to therapeutic levetiracetam dosing. Refereed/Peer-reviewed
- Subjects :
- Adult
Atropine
Bradycardia
Levetiracetam
medicine.medical_treatment
Oliguria
heart
Pharmacology
Toxicology
Drug overdose
Cardiovascular System
030226 pharmacology & pharmacy
03 medical and health sciences
0302 clinical medicine
Pharmacokinetics
Humans
Medicine
business.industry
Piracetam
General Medicine
medicine.disease
CNS/psychological
Anticonvulsant
Anesthesia
Female
Drug Overdose
Hypotension
medicine.symptom
business
anticonvulsant
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0551df22b62ee88f554978e58030c5a5