Olanzapin ve Ketiapin intoksikasyonuna İkincil Rabdomiyoliz

Abstract

Giriş: Rabdomiyoliz, antipsikotik ilaçlara bağlı nadir gelişen ve potansiyel olarak ciddi bir ilaç reaksiyonudur. Biz intihar amaçlı 200 mg Olanzapinve 6 gr Ketiapin alımı sonrasında rabdomiyoliz gelişen olgumuzu sunuyoruz. Olgu Sunumu: Kırk dokuz yaşında erkek hasta acil servise intihar amaçlı fazla miktarda Olanzapin ve Ketiapin içmesi nedeniyle getirildi. Laboratuar tetkiklerinde Kreatin kinaz (CK): 7761 U/L, Kreatin kinaz myokardial band (CKMB): 178 U/L, pH: 7,44, , Laktat: 0,50 mmol/L olup idrarda myoglobin testi pozitifti. Diğer parametreler normal sınırlar içerisindeydi. Bu ilaçları 2 yıldır kullanan hastanın daha önce bakılan laboratuar tahlillerinde enzim yüksekliklerine rastlanmamıştı. 2. Gün CK: 4008 U/L, CKMB: 100 U/L, 3. Gün CK: 1924 U/L, CKMB: 86 U/L, 4. Gün CK: 1510 U/L, CKMB: 80 U/L geldi. Yattığı süre içerisinde hastada böbrek fonksiyon bozukluğu ve metabolik asidoz gelişmedi. Yatışının 5. gününde taburcu edildi. Sonuç: Aşırı doz atipik antipsikotik drug alımlarından sonra mutlaka hastalar rabdomyoliz açısından da takip edilmelidir.

Keywords

• Rabdomiyoliz, olanzaopin, ketiapin

Rhabdomyolysis Secondary to Quetiapine and Olanzapine Intoxication

Abstract

Introduction: Rhabdomyolysis is a rare and potentially serious adverse drug reaction to antipsychotic medicines. We present a case that developed rhabdomyolysis following the intake of 200 mg olanzapine and 6 gr quetiapine for a suicide attempt.Case Report: A 49-year-old male patient was submitted to the emergency department with complaint of taking an excessive amount of olanzapine (10 mg) and quetiapine (300 mg) in order to commit suicide. As to the laboratory analysis, Creatine Kinase (CK): 7761 U/L, Creatine Kinase Myocardial Band (CKMB): 178 U/L, pH 7.44, HCO3: 22.9 mmol/L, lactate: 0.50 mmol/L, and the urine myoglobin test was positive. The other parameters were within the normal limits. The patient had been using the medicines for 2 years and has not been come across that high level for enzymes which had not previously been detected. On the second day, the results were CK: 4008 U/L and CKMB: 100 U/L; on the third day, CK: 1924 U/L and CKMB: 86 U/L; and on the fourth day, CK: 1510 U/L and CKMB: 80 U/L. During hospitalization, no renal function disorder or metabolic acidosis occurred. On the fifth day, the patient was discharged. Conclusion: After taking an excessive amount of atypical antipsychotic drugs, patients should necessarily be followed for the risk of developing of rhabdomyolysis

Keywords

• Rhabdomyolysis, olanzapine, quetiapine

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