Citation

Wong OF, Chan YC, Lam SK, Fung HT, Ho JKY. Hong Kong J. Emerg. Med. 2011; 18(4): 243-248.

Copyright

(Copyright © 2011, Medcom Limited)

DOI

10.1177/102490791101800410

PMID

unavailable

Abstract

Hydroxychloroquine overdose is a rare condition and often results in severe cardiovascular toxicities. We report 2 cases of fatal hydroxychloroquine overdose (1 patient had co-ingestion of chloroquine). Both patients developed refractory cardiovascular collapse and cardiac arrest soon after the drug overdose. Both of them were treated with high dose adrenaline and diazepam. However, they deteriorated rapidly despite the treatments. In view of similar toxicological profile of hydroxychloroquine to other lipophilic cardiotoxic medications, intravenous lipid emulsion was given as the last resort but both of them died eventually. Based on the clinical experience from these 2 cases, Intravenous lipid emulsion is not effective in reversing the cardiotoxic effects of hydroxychloroquine and chloroquine overdose.

Language: en

Keywords

adult; human; female; Poisoning; shock; case report; depression; schizophrenia; suicide attempt; drug overdose; article; clinical practice; drug intoxication; physical examination; diazepam; activated carbon; ingestion; cardiotoxicity; drug safety; drug efficacy; hypotension; heart arrest; systemic lupus erythematosus; lipophilicity; QT prolongation; adrenalin; bicarbonate; defibrillation; electrocardiogram; Glasgow coma scale; heart ventricle fibrillation; potassium; nasogastric tube; torsade des pointes; toxicity testing; thorax radiography; sinus tachycardia; blood gas analysis; hypokalemia; drug dose increase; cardiac resynchronization therapy; prednisolone; chloroquine; fluid resuscitation; hydroxychloroquine; toxicological parameters; repeated drug dose; echocardiography; drug dose escalation; lipid emulsion; intralipid; return of spontaneous circulation; Cardiotoxins; Torsades de pointes