Edoxaban
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Blood coagulation disorder following drug overdose: case report A 57-year-old woman developed blood coagulation disorder following drug overdose with edoxaban in an attempt to suicide. The woman, who had ingested single oral dose of edoxaban 750mg in an attempt to suicide, was admitted to hospital. Her anamnesis revealed various concomitant medications. Her plasma concentration during ambulance transport following ingestion was approximately 4900 ng/mL suggestive of drug overdose [duration of treatment to reaction onset not stated]. The woman received primary treatment with vitamin K. Plasma samples were analysed using liquid chromatography tandem mass spectrometry assays. Her edoxaban plasma concentration was 4920 ng/mL, 368 ng/mL, 154 ng/mL, 31 ng/ml at 8, 28, 36 and 52 hours respectively. The plasma concentrations was further detectable at 60 and 76 hours, but was considered unmeasurable (1.8 ng/mL) at 100 hours after administration. A simplified physiologically based pharmacokinetic (PBPK) model was studied for determining hepatic drug clearance. Clinical laboratory parameters showed prolonged activated partial thromboplastin times and prothrombin times consistent with blood coagulation disorder, which was noted from the beginning of hospitalisation to 13 hours following the ingestion of edoxaban; however no bleeding was noted. These parameter values had reduced to the normal levels at 28 hours and were maintained at normal levels up to 60 hours. Other laboratory blood test results were also essentially stable during the 60 hour observation period. Adachi K, et al. Pharmacokinetics of anticoagulant edoxaban in overdose in a Japanese patient transported to hospital. Journal of Pharmaceutical Health Care and Sciences 6: 803517263 20, No. 1, 11 Sep 2020. Available from: URL: http://doi.org/10.1186/s40780-020-00176-6
0114-9954/20/1832-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 28 Nov 2020 No. 1832
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