Intentional Hydroxychloroquine Overdose Treated with High-Dose Diazepam: an Increasing Concern in the COVID-19 Pandemic.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
Peter R ChaiT B Erickson

Abstract

Recent attention on the possible use of hydroxychloroquine and chloroquine to treat COVID-19 disease has potentially triggered a number of overdoses from hydroxychloroquine. Toxicity from hydroxychloroquine manifests with cardiac conduction abnormalities, seizure activity, and muscle weakness. Recognizing this toxidrome and unique management of this toxicity is important in the COVID-19 pandemic. A 27-year-old man with a history of rheumatoid arthritis presented to the emergency department 7 hours after an intentional overdose of hydroxychloroquine. Initial presentation demonstrated proximal muscle weakness. The patient was found to have a QRS complex of 134 ms and QTc of 710 ms. He was treated with early orotracheal intubation and intravenous diazepam boluses. Due to difficulties formulating continuous diazepam infusions, we opted to utilize an intermitted intravenous bolus strategy that achieved similar effects that a continuous infusion would. The patient recovered without residual side effects. Hydroxychloroquine toxicity is rare but projected to increase in frequency given its selection as a potential modality to treat COVID-19 disease. It is important for clinicians to recognize the unique effects of hydroxychloroquine po...Continue Reading

References

Nov 1, 1989·Therapeutic Drug Monitoring·D J GreenblattR I Shader
Jan 7, 1988·The New England Journal of Medicine·B RiouF J Baud
May 7, 1973·JAMA : the Journal of the American Medical Association·W Friedenberg, J D Barker
Jul 18, 1983·The American Journal of Medicine·E W McChesney
Jul 3, 1993·BMJ : British Medical Journal·K Meeran, M G Jacobs
Sep 19, 2000·The New England Journal of Medicine·K C WilsonH W Farber
Sep 14, 2001·The American Journal of Emergency Medicine·K Marquardt, T E Albertson
Aug 24, 2005·Virology Journal·Martin J VincentStuart T Nichol
Sep 10, 2015·Case Reports in Emergency Medicine·Paul B McBethVinay Dhingra
Jan 29, 2016·Journal of Pharmaceutical Health Care and Sciences·Yoshinori OnukiKozo Takayama
Dec 12, 2017·Ecancermedicalscience·Ciska VerbaanderdGauthier Bouche
Feb 9, 2020·Nature Reviews. Rheumatology·Eva Schrezenmeier, Thomas Dörner
Mar 10, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Xueting YaoDongyang Liu
Mar 21, 2020·International Journal of Antimicrobial Agents·Zahra SahraeiAli Saffaei
Jun 9, 2020·MedRxiv : the Preprint Server for Health Sciences·Joseph MagagnoliJayakrishna Ambati

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Citations

Sep 15, 2020·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Bruno Mégarbane, Azzurra Schicchi

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Methods Mentioned

BETA
sedation
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