Various drugs
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Deters M, et al. Iatrogenic intravenous medication errors reported to the PIC 801158285 Erfurt. Clinical Toxicology 47: 169-173, No. 2, 2009 - Germany
Multiple toxicities as a result of IV and peridural medication errors: 9 case reports Nine patients were identified in a retrospective study as having experienced multiple toxicities as a result of IV and peridural medication errors with chlorpromazine, lidocaine, midazolam, potassium chloride, sucralfate or vancomycin; one patient died as a result. An adult [age unknown, sex not stated] received sucralfate 5mL intravenously instead of orally [therapeutic indication not stated], and developed tachycardia and respiratory insufficiency [time to reaction onset not stated]. The patient was intubated and ventilated. Deferoxamine was administered because of aluminium overdose, and recovery was complete. Causality was probable. An 80-year-old woman was administered < 5mL sucralfate intravenously instead of orally [therapeutic indication not stated], and developed respiratory insufficiency and a skin rash [time to reaction onset not stated]. She was intubated and ventilated, and completely recovered. Causality was probable. A 68-year-old woman received an overdose of IV lidocaine 1000mg, instead of 100mg, because of VES [not defined]. One minute later, she experienced a seizure. She underwent heart massage, intubation and ventilation, as well as pacemaker stimulation [outcome not stated]. Causality was possible. A 32-year-old woman was given an overdose of IV midazolam 15mg for a suspected amfetamine overdose, and fell into a coma [time to reaction onset not stated]. Flumazenil was administered, and she was monitored. She recovered fully; causality was probable. A 5-year-old boy was administered an overdose of IV chlorpromazine 50mg due to vomiting during chemotherapy. He subsequently fell into a coma and had a seizure [time to reaction onset not stated]. He was treated with diazepam and monitored. The next day, he was somnolent; a differential diagnosis was not yet complete at that time [outcome not stated]. Causality was possible. A man [age unknown] received IV vancomycin 250mg in a possible overdose or possible fast injection [therapeutic indication not stated]. He became asystolic and developed renal insufficiency [time to reaction onset not stated]. He was resuscitated but had sustained severe hypoxia-induced brain damage. Causality was possible. A 55-year-old woman received 7.5% potassium chloride 35mL peridurally instead of intravenously [therapeutic indication not stated]. Ninety minutes later, she started to experience leg paraesthesia. After 2.5 hours, there was paraplegia and a reduction in vigilance. One hour later, she experienced respiratory insufficiency, tachycardia, diaphoresis, hypertonus and mydriasis. She was given a peridural infusion of 0.9% sodium chloride 50 mL/hour over 5 hours, with intubation and ventilation. The muscle tonus increased 4 hours after the infusion began, and after 11 hours, her neurological symptoms had resolved. Causality w
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