Citation

Fagan NL, Wear RE, Malesker MA, Morrow LE, Schuller D. Hosp. Pharm. 2010; 45(1): 49-53.

Copyright

(Copyright © 2010, Thomas Land Publishers)

DOI

10.1310/hpj4501-49

PMID

unavailable

Abstract

PURPOSE: To report the case of a colchicine overdose to highlight current limitations in the treatment of this toxicologic emergency. Summary: A 23-year-old man was admitted to the intensive care unit (ICU) after attempting suicide via polypharmacy ingestion, which included 80 to 100 colchicine 0.6 mg tablets (approximately 0.9 mg/kg of body weight). He was taken to the emergency department where gastric decontamination was initiated. Because attempts to obtain a colchicine-specific antibody fragment (Fab) were unsuccessful, only supportive therapies were provided throughout his hospitalization. Over the course of several days, the patient experienced the 3 separate evolutionary phases of colchicine toxicity ultimately leading to multiple organ failure and hemodynamic collapse, and death.

CONCLUSION: Acute colchicine intoxication is a rare, but potentially life-threatening event. Although 1 case report demonstrated the successful use of a colchicine-specific Fab fragment in the management of acute colchicine overdose, there is presently no commercially-available antidote for colchicine toxicity. Prompt recognition of the overdose, aggressive gastrointestinal decontamination, and supportive therapies directed at the multi-organ failure remain the standard of care.

Language: en

Keywords

Overdose; Colchicine; Adverse reaction; Colchicine-specific fab fragment