Treatment of polypharmacy overdose with multimodality extracorporeal life support

A 45-year-old woman presented to the emergency department of a tertiary referral hospital after taking an overdose of verapamil, doxepin, quetiapine, diazepam, temazepam, and clonazepam. She rapidly developed shock refractory to pharmacological support and was placed on percutaneous venoarterial ext...

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Bibliographic Details
Published inAnaesthesia and intensive care Vol. 33; no. 1; pp. 120 - 123
Main Authors MACLAREN, G, BUTT, W, CAMERON, P, PREOVOLOS, A, MCEGAN, R, MARASCO, S
Format Journal Article
LanguageEnglish
Published Edgecliff Anaesthesia and Intensive Care 01.02.2005
Sage Publications Ltd
Subjects
Acidosis - chemically induced
Acidosis - therapy
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Drug Overdose
Emergency Service, Hospital
Extracorporeal Membrane Oxygenation
Female
Humans
Medical sciences
Middle Aged
Pharmaceutical Preparations - administration & dosage
Plasma Exchange
Poisoning - therapy
Renal Dialysis
Atypical antipsychotic
Neuroleptic
Psychotropic
Overdosing
Calcium antagonist
Reuptake inhibitor
intoxication
Plasma exchange
Aralkylamine
Anesthesia
Antidepressant agent
extracorporeal membrane oxygenation
Dibenzothiazepine derivatives
Quetiapine
Doxepin
QUETIAPINE: polypharmacy overdose
Hypnotic
Catecholamine
Tricyclic compound
Antiarrhythmic agent
Plasmapheresis
Treatment
Tranquillizer
Verapamil
Norepinephrine
Poisoning
Overdose
Oxygenation
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Summary:A 45-year-old woman presented to the emergency department of a tertiary referral hospital after taking an overdose of verapamil, doxepin, quetiapine, diazepam, temazepam, and clonazepam. She rapidly developed shock refractory to pharmacological support and was placed on percutaneous venoarterial extracorporeal membrane oxygenation (ECMO). She had a severe metabolic acidosis from a combination of shock and drug intoxication that improved with continuous venovenous haemodialysis. Forty-eight hours after presentation, while still on ECMO, the patient had complete cardiac standstill for three and a half hours, attributable to slow-release verapamil, that resolved after the commencement of plasmapheresis. The role of plasmapheresis in verapamil overdose requires further study.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X0503300118