Potassium-chloride overdose
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Pharmacobezoar, poisoning and hyperkalaemia: case report. A 47-year-old woman developed hyperkalaemia and pharmacobezoar following potassium chloride poisoning after a selfadministered overdose of potassium chloride in a suicide attempt. The woman with a negative medical history was admitted after self administering 50 tablets of potassium chloride in a suicide attempt. She took the tablets 1.5 hours before admission. Upon admission she was alert with stable vital parameters and unremarkable physical examination. She showed moderate hyperkalaemia with potassium levels of 6.7 mmol/L. Her ECG was normal. Gastric decontamination did not reveal any tablet fragments. Antero-posterior abdominal X-ray demonstrated a mass in the stomach, noted to be a conglomerate of a large number of tablets (pharmacobezoar). Gastric decontamination was repeated in trendelenburg position but was unsuccessful. Subsequently, arterial blood gas analysis revealed elevated serum potassium concentration suggestive of potassium poisoning, and the ECG showed progressive worsening of T-waves. The woman was treated with calcium gluconate, sodium bicarbonate, glucose-insulin therapy, sodium polystyrene sulfonate [polystyrene sulfonate] and furosemide. However, her serum potassium concentration did not improve. Subsequently, she underwent intestinal decontamination with urgent upper panendoscopy and 39 whole intact tablets were removed. Eventually, her serum potassium concentration showed rapid improvement. Magocs D, et al. Pharmacobezoar and the holistic approach. Clinical Toxicology 58: 630-631, No. 6, May 2020. Available from: URL: http:// doi.org/10.1080/15563650.2020.1741981 [abstract]
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Reactions 26 Sep 2020 No. 1823
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