Refractory Hypotension Caused by Prazosin Overdose Combined With Acetaminophen and Naproxen Toxicity: A Case Report and Review of the Literature.
J Emerg Med
; 55(6): e141-e145, 2018 12.
Article
in En
| MEDLINE
| ID: mdl-30287134
ABSTRACT
BACKGROUND:
Pediatric exposure to prazosin is unusual because it is most commonly indicated for the treatment of hypertension. Prazosin's increase in popularity as a treatment for posttraumatic stress disorder makes it important for emergency physicians to be aware of how to manage potential toxic ingestion because of prazosin overdose. CASE REPORT A 16-year-old, 76-kg female presented after ingesting 110 mg of prazosin, 209.3 g of acetaminophen, and 55 g of naproxen. She was admitted to the pediatric intensive care unit for rapidly deteriorating hypotension (lowest blood pressure 47/19 mm Hg) refractory to aggressive fluid resuscitation and infusions of epinephrine and norepinephrine each at 0.5 mcg/kg/min. Stabilization of blood pressure was eventually achieved, and associated with use of a vasopressin infusion of 0.004 units/kg/min. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Because of the increasing exposure of children to prazosin, clinicians should be aware of the pharmacology behind alpha-1 antagonist overdose and consider treatment options, such as vasopressin, when hypotension is resistant to standard fluid and catecholamine therapy.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Prazosin
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Anti-Inflammatory Agents, Non-Steroidal
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Naproxen
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Analgesics, Non-Narcotic
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Drug Overdose
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Hypotension
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Acetaminophen
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Antihypertensive Agents
Limits:
Adolescent
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Female
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Humans
Language:
En
Year:
2018
Type:
Article