Chloroquine poisoning. Rapidly fatal without treatment.

Meeran, Karim; Jacobs, Marina Gasino

doi:10.1136/bmj.307.6895.49

Cited by 25 publications

(10 citation statements)

References 6 publications

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“…Given concerns for rapid potassium shifts in toxicity and repletion, an alternative to succinylcholine should be considered for rapid sequence induction and paralysis to avoid provoking rapid onset of hyperkalemia. Additionally, clinicians should avoid barbiturates for induction, as they may precipitate sudden cardiac arrest [ 96 ].…”

Section: Discussionmentioning

confidence: 99%

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Porta

Bornstein

Coye

et al. 2020

The American Journal of Emergency Medicine

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Background Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality. Objective This review describes acute chloroquine and hydroxychloroquine toxicity, outlines the complex pathophysiologic derangements, and addresses the emergency department (ED) management of this patient population. Discussion Chloroquine and hydroxychloroquine are aminoquinoline derivatives widely used in the treatment of rheumatologic diseases including systemic lupus erythematosus and rheumatoid arthritis as well as for malaria prophylaxis. In early 2020, anecdotal reports and preliminary data suggested utility of hydroxychloroquine in attenuating viral loads and symptoms in patients with SARS-CoV-2 infection. Aminoquinoline drugs pose unique and significant toxicological risks, both during their intended use as well as in unsupervised settings by laypersons. The therapeutic range for chloroquine is narrow. Acute severe toxicity is associated with 10–30% mortality owing to a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias. Treatment in the ED is focused on decontamination, stabilization of cardiac dysrhythmias, hemodynamic support, electrolyte correction, and seizure prevention. Conclusions An understanding of the pathophysiology of acute chloroquine and hydroxychloroquine toxicity and available emergency treatments can assist emergency clinicians in reducing the immediate morbidity and mortality associated with this disease.

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Section: Discussionmentioning

confidence: 99%

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Porta

Bornstein

Coye

et al. 2020

The American Journal of Emergency Medicine

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“…Oral chloroquine is rapidly and almost completely absorbed from the GI tract, leading to rapid signs of toxicity with cardiac and neurologic systems predominating (4). As a result, ingestion of a surprisingly small amount of chloroquine has severe effects.…”

Section: Characteristicsmentioning

confidence: 99%

Are 1–2 dangerous? Chloroquine and hydroxychloroquine exposure in toddlers

Smith

Klein‐Schwartz

2005

The Journal of Emergency Medicine

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“…Chloroquine (CQ) was first synthesized in 1934 by the Bayer scientist Johann Anderstag and initially given the name resorchin (RESORcinate of 4‐aminoCHINolin) . Originally deemed too toxic for use in humans, it was rediscovered in the 1940s and has been widely used against malaria, with a high degree of success, since the 1950s . Several side effects result from excessive use of CQ, such as gastrointestinal distress, retinopathy, cardiac toxicity, and even death .…”

Section: Figurementioning

confidence: 99%

“…Several side effects result from excessive use of CQ, such as gastrointestinal distress, retinopathy, cardiac toxicity, and even death . These contraindications are likely due to CQ being a noted negative ionotrope, vasodilator, and inhibitor of intraventricular conduction . Malaria treatment requires high doses of CQ (up to 1 500 mg) over several days .…”

Section: Figurementioning

confidence: 99%

The Lysosomal Protein Saposin B Binds Chloroquine

et al. 2015

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Chloroquine has been widely used in the treatment of malaria since the 1950’s. CQ is also becoming an important therapeutic compound for the treatment of auto-immune disorders and has shown activity as an anti-cancer agent. The full extent of CQ pharmacology in humans is still unclear. Herein, we demonstrate that the lysosomal protein saposin B, critical for select lipid degradation, binds chloroquine with implications for both chloroquine function and toxicity.

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Chloroquine poisoning. Rapidly fatal without treatment.

Cited by 25 publications

References 6 publications

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Acute chloroquine and hydroxychloroquine toxicity: A review for emergency clinicians

Are 1–2 dangerous? Chloroquine and hydroxychloroquine exposure in toddlers

The Lysosomal Protein Saposin B Binds Chloroquine

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