Citation

Mitrović D, Assendorp A, Bethlehem C, de Boer H, Ten Hoeve E. Pharm. Weekbl. 2018; 153(14): 13-16.

Copyright

(Copyright © 2018, D B Centens Witgeversmij)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION The number of reports on baclofen intoxication has increased in recent years. This is related to the increasing use of baclofen in the treatment of alcohol and gamma-hydroxybutyric acid withdrawal and as recreative drug. DESCRIPTION A 27-year-old man with a history of psychiatric comorbidity and an addiction problem was brought to the emergency department IEDI in an unresponsive state (EMV score 3) after an attempted suicide with medication. After hetero-anamnesis, he was diagnosed with an intoxication of 850 mg baclofen, 2.5 liters' beer and an unknown amount of heroine. He was intubated because of respiratory failure. Besides, activated charcoal in combination with a laxative was administered. Morphine and midazolam were administered to prevent withdrawal symptoms. The EMV score improved 30 hours after admission and he was detubated 60 hours after admission.

DISCUSSION AND CONCLUSION The treatment of a baclofen intoxication consists of supportive care. This case demonstrates the importance of keeping a baclofen intoxication in mind in the differential diagnoses when a comatose or confused patient with addiction problems is brought in at the ED. Baclofen levels cannot be determined with standard drug screening so considering specific laboratory testing is necessary to detect baclofen intoxication. © 2018 Kon. Ned. Mij. ter Bevordering der Pharmacie (KNMP). All rights reserved.

Language: nl

Keywords

adult; human; male; case report; scoring system; suicide attempt; addiction; emergency care; comorbidity; laxative; mental disease; differential diagnosis; clinical article; drug intoxication; disease course; morphine; activated carbon; confusion; diamorphine; drug screening; anamnesis; withdrawal syndrome; respiratory failure; midazolam; laboratory test; baclofen; Article; intubation; comatose patient; medical history; beer; EMV score