Hypokalaemia related to acute chloroquine ingestion

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

“…The primary effects include EKG abnormalities with prolonged PR, QRS and QT intervals, ventricular dysrhythmias, and profound hypotension often progressing suddenly to cardiovascular collapse and shock with increased central venous pressure. Chloroquine's chemical structure incorporates a quinidine ring that exerts toxicity on the cardiac conduction system and the myocardium by a quinidinelike mechanism including negative inotropism, inhibition of spontaneous diastolic depolarization, slowed intraventricular conduction, increase of effective refractory period, prolongation of QRS and QT intervals, Torsade de Pointes, and ventricular ectopic beats (11,12). Profound refractory hypotension is a common result.…”

“…Central nervous system (CNS) effects vary, but drowsiness is the most common symptom followed by seizures that are difficult to control. Hyperexcitability, irritability or agitation, and altered mental status progressing to coma also have been reported (12). Central nervous system manifestations are believed to be a combination of direct toxic effect of chloroquine on brain tissue as well as damage from hypoxia and hypoperfusion (13).…”

“…Due to this intracellular potassium shift, the hypokalemia has a tendency to self-correct as the intoxication resolves (1). The severity of hypokalemia closely correlates with the level of chloroquine toxicity (12). Potassium concentrations less than 1.9 mEq/L are correlated with severe, life-threatening ingestion (18).…”

Intoxication grave de l'adulte : épidémiologie, définition, critères d'admission en réanimation

“…La mortalité est de 1,6 % pour une chloroquinémie entre 12-25 μM et de 21,3 % si supérieure ou égale à 25 μM, alors qu'elle est nulle si inférieure ou égale à 10 μM (concentration thérapeutique ≤ 6 μM) [24]. L'hypokaliémie de transfert est directement corrélée à la gravité de l'intoxication [25]. Une valeur inférieure à 3 mmol/l est prédictive d'une surmortalité.…”

Drugs that cause torsades de pointes and increase the risk of sudden cardiac death

“…Although halofantrine is a significantly more potent inhibitor than chloroquine, the latter drug has been linked with TdP when used in combination with astemizole [29]. Additionally, large doses of chloroquine can cause hypokalemia, which can increase the risk of life-threatening arrhythmias [30]. These drugs should not be used with other QT-prolonging drugs, especially those metabolized by CYP2D6 [28].…”