Monosodium phosphate/disodium phosphate
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Acute respiratory failure due to drug toxicity following medication error: case report A 3-month-old boy developed acute respiratory failure due to monosodium phosphate/disodium phosphate toxicity following its administration as a laxative, erroneously by oral route. The boy, who was born prematurely at 30 weeks of gestation age, had a history of constipation. He presented to the emergency department due to lethargy, poor enteral intake, increased breathing and 2 episodes of emesis. Upon examination, he was unresponsive with poor respiratory effort, which prompted endotracheal intubation. A CT scan of the brain showed chronic, small germinal matrix haemorrhage. A urine toxicology screen and a skeletal survey showed normal results. Blood work showed hypernatraemia, anion gap metabolic acidosis, severe hypocalcaemia and hyperphosphataemia [time to reactions onsets not stated]. Hence, the boy was treated with unspecified broadspectrum antibiotics and admitted to the ICU for evaluation. He was treated with calcium chloride and IV fluids, and subsequently, his calcium level recovered. Upon anamnesis, it was revealed that his father had administered him multiple doses [specific doses not stated] of monosodium phosphate/ disodium phosphate [Fleetc] enema as laxative, erroneously by mouth. His serum phosphate level was 9.5 mg/dL. Following next week, findings of his neurologic exam were normal, and he was extubated. Additionally, his electrolytes remained stable with no supplementation. Author comment: "We present an unusual case of acute respiratory failure in a chronically constipated 3-month old secondary to sodium phosphate toxicity after oral administration of [monosodium phosphate/disodium phosphate] enema." "Our case is unique as the etiology was inappropriate oral administration leading to greater systemic uptake and resultant toxicity." Sochet A, et al. A fleeting case of acute respiratory failure in a 3-month old infant. Critical Care Medicine 47 (Suppl. 1): 214 abstr. 468, No. 1, Jan 2019. Available from: URL: https://journals.lww.com/ccmjournal/ Citation/2019/01001/468__A_FLEETING_CASE_OF_ACUTE_RESPIRATORY_FAILURE.431.aspx 803432044 [abstract] - USA
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Reactions 9 Nov 2019 No. 1778
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