4 Case of Rhabdomyolysis due to Doxylamine Intoxication.
- Author:
Jong Hoon YOO
1
;
Eui Hyuk CHOI
;
Jeong Seok LEE
;
Su Hee HONG
;
Hyoung Ju KOUN
;
Mu Yeul LEE
;
Young U PARK
;
Chul Ho LEE
;
Bo Jeong SEO
;
Dong Yun LEE
;
Jun Sang LEE
Author Information
1. Department of Internal Medicine, Wallace Memorial Baptist Hospital, Pusan, Korea.
- Publication Type:Case Report
- Keywords:
Rhabdomyolysis;
Doxylamine;
Creatine phosphokinase
- MeSH:
Adult;
Autonomic Agents;
Central Nervous System;
Charcoal;
Creatine;
Creatine Kinase;
Creatinine;
Doxylamine*;
Eating;
Emergency Service, Hospital;
Gastric Lavage;
Humans;
Muscle, Striated;
Rhabdomyolysis*;
Suicide;
Technetium Tc 99m Medronate;
Urinalysis
- From:Korean Journal of Nephrology
1999;18(3):494-500
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Doxylamine is common over-the-counter sleep preparations & frequently involved in overdoses. The clinical course is dominated by the anticholinergic effects, including central nervous system & autonomic effects. We report 4 cases of suicide attempts in adults where ingestion of the doxylamines were complicated by rhabdomyolysis. They ingested doxylamines variable amount & were carried to emergency department. They complained gastrointestinal or central nervous system symptoms. Gastric lavages & administrations of activated charcoal were done. Creatine phosphok inase levels were normal or markedly elevated on arrival, but peaked several days later. Serum creatinine levels were normal. 99mTc-MDP bone scans were showed increased muscle labelling at the regions of muscle injury. They were treated with hydration, urine alkalinization, & supportive measures in hospital. On considering cause of rhabdomyolysis, our patients did not show any evidence of viral illness or coingestion of other potential myopathic toxins to support a secondary cause of rhabdomyolysis. The mechanism of rhabdomyolysis in cases of doxylamine overdose seems to be a direct toxic effect of the drug on striated muscle, but the exact mechanism is not clear. In all cases where such overdoses are suspected, consideration should be given to obtaining a urinalysis & a creatine phosphokinase level on arrival & creatine phosphokinase levels are carefully followed. Primary detoxication included gastric lavage & administration of activated charcoal. The patient's urine output & renal function should be closely monitored.
