Glucagon
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Lack of efficacy: case report A 37-year-old man exhibited lack of efficacy during treatment with glucagon for toxic hypoglycaemic syndrome (THS). The man presented with confusion and lethargy. Anamnesis revealed that he had developed nausea, vomiting and diarrhoea soon after eating ackee fruit. He had presented to the emergency department the following day with vomiting and abdominal pain, and had been discharged with a diagnosis of acute gastritis. The following day, he was found to be confused while he laid in a pool of vomitus. Upon current presentation, finger stick glucose was found to be 56 mg/dL. He also developed severe metabolic acidosis. He was treated with IV fluids and glucose [dextrose], and he was admitted to an intermediate care unit. However, he experienced worsening hypoglycaemia and confusion over the following 24 hours. He underwent endotracheal intubation due to encephalopathy. Thereafter, he received glucagon [route and dosage not stated]. However, no response to glucagon was noted. Therefore, the man required a continuous infusion of glucose. By day 3, the encephalopathy was noted to have improved, and he was taken off mechanical ventilation. He required glucose infusion for a week to maintain euglycaemia. He was diagnosed with THS secondary to the consumption of the ackee fruit. Bangash B, et al. A case of toxic hypoglycemic syndrome secondary to ackee fruit poisoning. American Journal of Respiratory and Critical Care Medicine 199: (plus poster), 803446318 No. 9, May 2019. Available from: URL: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A4833 [abstract]
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Reactions 18 Jan 2020 No. 1787
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