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Multiple drugs poisoning resulting in ARDS

Year 2014, Volume: 5 Issue: 3, - , 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0442

Abstract

Inappropriate use of prescribed antidepressants and antipsychotics may frequently cause death due to cardiac complications. Lung complications are rare. We present a case of acute respiratory distress syndrome due to suicide attempt with quetiapine, carbamazepine, and clomipramine. The patient developed pulmonary edema and hypoxemia refractory to oxygen treatment. The patient died due to septic shock and multi-organ failure at the tenth day of intensive care treatment, despite recruitment maneuvers and lung-protective ventilation. Cases of allergic lung edema due to clomipramine are very rare in the literature. When considering the fact that all three drugs may elevate serum concentrations of each other, we are in opinion that the sinergistic effect of three drugs may be the cause. J Clin Exp Invest 2014; 5 (3): 466-468

References

  • Kekeç Z, Sözüer EM, Duymaz H, et al. Acil servise baş- vuran çoklu ilaç zehirlenmelerinin yedi yıllık analizi. Türkiye Acil Tıp Dergisi 2005;5:69-72.
  • Hasnain M, Vieweq WV, Howland RH, et al. Quetiap- ine, QTc interval prolongation, and torsade de pointes: a review of case reports. Ther Adv Psychopharmacol 2014;4:130-138.
  • Santana NO, Gois AF. Rhabdomyolysis as a manifes- tation of clomipramine poisoning. Sao Paulo Med J 2013;131:432-435.
  • Patel VH, Schindlebeck MA, Bryant SM. Delayed el- evation in carbamazepine concentrations after over- dose: a retrospective poison center study. Am J Ther 2013;20:602-606.
  • Sikma M, van den Broek MP, Meulenbelt J. Increased unbound drug fraction in acute carbamazepine intoxi- cation: suitability and effectiveness of high-flux hae- modialysis. Intensive Care Med 2012;38:916-917.
  • Fanoe S, Kristensen D, Fink-Jensen A, et al. Risk of arrhythmia induced by psychotropic medications: a proposal for clinical management. Eur Heart J 2014;35:1306-1315.
  • Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526-2533.
  • Şen A, Tomak Y, Erdivanlı B, Kurt A. Ketiapine bağlı ge- lişen kardiyak arrest ve bilinç kapanması. Turk Yogun Bakim Derg 2012;10:131-133.
  • Trenton A, Currier G, Zwemer F. Fatalities associated with therapeutic use and overdose of atypical antipsy- chotics. CNS Drugs 2003;17:307-324.
  • Soderstrom J, Murray L, Little M, et al. Toxicology case of the month: carbamazepine overdose. Emerg Med J 2006;23:869-871.
  • Soriano FG, Vianna ES, Velasco IT. Neuroleptic in- duced acute respiratory distress syndrome. Sao Pau- lo Med J 2003;121:121-124.
  • Li C, Gefter WB. Acute pulmonary oedema induced by overdosage of phenothiazines. Chest 1992;101:102-104.
  • Savici D, Katzenstein AL. Diffuse alveolar damage and recurrent respiratory failure report of 6 cases. Hum Pathol 2001;32:1398-1402.
  • Dale O, Hole A. Biphasic time-course of serum con- centrations of clomipramine and desmethylclomip- ramine after a near-fatal overdose. Vet Hum Toxicol 1994;36:309-310.
  • Fuente JM, Mendlewicz J. Carbamazepine addition in tricyclic antidepressant-resistant unipolar depression. Biol Psychiatry 1992;32:369-374.
  • Gerson GR, Jones RB, Luscombe DK. Studies on the concomitant use of carbamazepine and clomipramine for the relief of post-herpetic neuralgia. Postgrad Med J 1977;53:104-109.

ARDS ile sonuçlanan çoklu ilaç zehirlenmesi

Year 2014, Volume: 5 Issue: 3, - , 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0442

Abstract

Reçete edilen antidepresan ve antipsikotiklerin uygunsuz kullanımına bağlı kardiyak komplikasyonlar sık gözlenir ve ölüme yol açabilir. Akciğer komplikasyonları ise seyrektir. Ketiapin, karbamazepin ve klomipramin ile intihar girişimi sonucu akciğer ödemi ve oksijen tedavisine yanıtsız hipoksi gelişen akut respiratuar yetmezlikli bir olguyu sunduk. Recruitment manevraları ve akciğeri koruyucu ventilasyona rağmen, yoğun bakımdaki tedavisinin onuncu gününde septik şok ve çoklu organ yetmezliği nedeniyle kaybedildi. Literatür araştırmalarında, klomipramine bağlı alerjik akciğer ödemi tablosunun nadir olarak görülebildiği belirtilmektedir. Her üç ilacın da birbirinin serum seviyesini etkileyebildiği dikkate alındığında, tabloya üç ilacın sinerjistik etkisinin neden olduğu düşüncesindeyiz.

References

  • Kekeç Z, Sözüer EM, Duymaz H, et al. Acil servise baş- vuran çoklu ilaç zehirlenmelerinin yedi yıllık analizi. Türkiye Acil Tıp Dergisi 2005;5:69-72.
  • Hasnain M, Vieweq WV, Howland RH, et al. Quetiap- ine, QTc interval prolongation, and torsade de pointes: a review of case reports. Ther Adv Psychopharmacol 2014;4:130-138.
  • Santana NO, Gois AF. Rhabdomyolysis as a manifes- tation of clomipramine poisoning. Sao Paulo Med J 2013;131:432-435.
  • Patel VH, Schindlebeck MA, Bryant SM. Delayed el- evation in carbamazepine concentrations after over- dose: a retrospective poison center study. Am J Ther 2013;20:602-606.
  • Sikma M, van den Broek MP, Meulenbelt J. Increased unbound drug fraction in acute carbamazepine intoxi- cation: suitability and effectiveness of high-flux hae- modialysis. Intensive Care Med 2012;38:916-917.
  • Fanoe S, Kristensen D, Fink-Jensen A, et al. Risk of arrhythmia induced by psychotropic medications: a proposal for clinical management. Eur Heart J 2014;35:1306-1315.
  • Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526-2533.
  • Şen A, Tomak Y, Erdivanlı B, Kurt A. Ketiapine bağlı ge- lişen kardiyak arrest ve bilinç kapanması. Turk Yogun Bakim Derg 2012;10:131-133.
  • Trenton A, Currier G, Zwemer F. Fatalities associated with therapeutic use and overdose of atypical antipsy- chotics. CNS Drugs 2003;17:307-324.
  • Soderstrom J, Murray L, Little M, et al. Toxicology case of the month: carbamazepine overdose. Emerg Med J 2006;23:869-871.
  • Soriano FG, Vianna ES, Velasco IT. Neuroleptic in- duced acute respiratory distress syndrome. Sao Pau- lo Med J 2003;121:121-124.
  • Li C, Gefter WB. Acute pulmonary oedema induced by overdosage of phenothiazines. Chest 1992;101:102-104.
  • Savici D, Katzenstein AL. Diffuse alveolar damage and recurrent respiratory failure report of 6 cases. Hum Pathol 2001;32:1398-1402.
  • Dale O, Hole A. Biphasic time-course of serum con- centrations of clomipramine and desmethylclomip- ramine after a near-fatal overdose. Vet Hum Toxicol 1994;36:309-310.
  • Fuente JM, Mendlewicz J. Carbamazepine addition in tricyclic antidepressant-resistant unipolar depression. Biol Psychiatry 1992;32:369-374.
  • Gerson GR, Jones RB, Luscombe DK. Studies on the concomitant use of carbamazepine and clomipramine for the relief of post-herpetic neuralgia. Postgrad Med J 1977;53:104-109.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Ersagun Tuğcugil This is me

Ahmet Şen This is me

Başar Erdivanlı This is me

Abdullah Özdemir This is me

Hızır Kazdal This is me

Publication Date September 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 3

Cite

APA Tuğcugil, E., Şen, A., Erdivanlı, B., Özdemir, A., et al. (2014). ARDS ile sonuçlanan çoklu ilaç zehirlenmesi. Journal of Clinical and Experimental Investigations, 5(3). https://doi.org/10.5799/ahinjs.01.2014.03.0442
AMA Tuğcugil E, Şen A, Erdivanlı B, Özdemir A, Kazdal H. ARDS ile sonuçlanan çoklu ilaç zehirlenmesi. J Clin Exp Invest. September 2014;5(3). doi:10.5799/ahinjs.01.2014.03.0442
Chicago Tuğcugil, Ersagun, Ahmet Şen, Başar Erdivanlı, Abdullah Özdemir, and Hızır Kazdal. “ARDS Ile sonuçlanan çoklu Ilaç Zehirlenmesi”. Journal of Clinical and Experimental Investigations 5, no. 3 (September 2014). https://doi.org/10.5799/ahinjs.01.2014.03.0442.
EndNote Tuğcugil E, Şen A, Erdivanlı B, Özdemir A, Kazdal H (September 1, 2014) ARDS ile sonuçlanan çoklu ilaç zehirlenmesi. Journal of Clinical and Experimental Investigations 5 3
IEEE E. Tuğcugil, A. Şen, B. Erdivanlı, A. Özdemir, and H. Kazdal, “ARDS ile sonuçlanan çoklu ilaç zehirlenmesi”, J Clin Exp Invest, vol. 5, no. 3, 2014, doi: 10.5799/ahinjs.01.2014.03.0442.
ISNAD Tuğcugil, Ersagun et al. “ARDS Ile sonuçlanan çoklu Ilaç Zehirlenmesi”. Journal of Clinical and Experimental Investigations 5/3 (September 2014). https://doi.org/10.5799/ahinjs.01.2014.03.0442.
JAMA Tuğcugil E, Şen A, Erdivanlı B, Özdemir A, Kazdal H. ARDS ile sonuçlanan çoklu ilaç zehirlenmesi. J Clin Exp Invest. 2014;5. doi:10.5799/ahinjs.01.2014.03.0442.
MLA Tuğcugil, Ersagun et al. “ARDS Ile sonuçlanan çoklu Ilaç Zehirlenmesi”. Journal of Clinical and Experimental Investigations, vol. 5, no. 3, 2014, doi:10.5799/ahinjs.01.2014.03.0442.
Vancouver Tuğcugil E, Şen A, Erdivanlı B, Özdemir A, Kazdal H. ARDS ile sonuçlanan çoklu ilaç zehirlenmesi. J Clin Exp Invest. 2014;5(3).