Citation

Frank SE, Snyder JT. Am. J. Emerg. Med. 1991; 9(1): 43-46.

Copyright

(Copyright © 1991, Elsevier Publishing)

DOI

10.1016/0735-6757(91)90013-a

PMID

1898701

Abstract

Survival following attempted suicide in a 50-year-old man by ingestion of 12.4 g of mexiletine, 620 mg of nifedipine and 50 to 100 tablets of sublingual nitroglycerine 1:150 is reported. Initial presentation was that of mental obtundation, vomiting, tonic-clonic seizure, high-degree atrioventricular block, profound vasodilation and cardiovascular collapse. Treatment consisted of intravenous calcium gluconate and aggressive fluid management. Maintenance of cardiovascular stability required continuous infusion phenylephrine, dopamine and epinephrine. The patient made a full recovery and was medically discharged on the fourth hospital day. This case represents the largest overdose of mexiletine to date to end in patient survival.

Language: en

Keywords

Hemodynamics; Humans; Male; Mexiletine; Middle Aged; Nifedipine; Nitroglycerin; Poisoning; Suicide, Attempted