Therapeutic trial of diazepam versus placebo in acute chloroquine intoxications of moderate gravity

Clemessy, Jean‐Luc; Angel, G; Borron, Stephen W.; Ndiaye, M.; Brun, Francisco; Julien, Howard; Galliot, M; Vicaut, Éric; Fj, Baud

doi:10.1007/s001340050271

Cited by 12 publications

(16 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There was no difference in evolution of the systolic BP, QRS duration and QT interval over 24 hours between the two groups. 20 The mechanism of action of diazepam in chloroquine intoxication is not well understood. The possible antiarrhythmic properties could be due to a decrease of sympathetic output in the central nervous system and peripheral benzodiazepine receptor mediated regulation of the cardiac calcium channels.…”

Section: Discussionmentioning

confidence: 99%

A Case of Fatal Hydroxychloroquine Overdose

Fung¹,

Lam²,

Wong³

et al. 2007

Hong Kong j. emerg. med.

View full text Add to dashboard Cite

A 28-year-old woman ingested 20 g of hydroxychloroquine sulphate for suicidal attempt. She developed hypotension, cardiac conduction disturbance, hypokalemia and hypoglycemia. Despite treatment with mechanical ventilation, epinephrine, sodium bicarbonate, diazepam and potassium replacement, she succumbed 10 hours post-overdose. Previous case reports of hydroxychloroquine overdose are summarised and the therapeutic choices are discussed. (Hong Kong j.emerg.med. 2007;14:53-57) (Figure 1). Twenty grams of dextrose given intravenously brought her GCS to 15/15 and blood glucose to 13.4 mmol/L. The BP was improved to 80/50 mmHg after infusion of 1 L of normal saline. Gastrointestinal decontamination was performed with 50 g of oral activated charcoal but gastric lavage was not done.She was later transferred to the Intensive Care Unit. She remained conscious but the BP and central venous pressure were 57/35 mmHg and 26 cmH 2 O respectively. She was intubated and put on synchronised intermittent mandatory ventilation mode of mechanical ventilation. The medications given included intravenous diazepam 60 mg followed by infusion of 2 mg/h, epinephrine 20 µg/min and sodium bicarbonate 100 mmol. The serum potassium three hours after the overdose was 1.5 mmol/L. Potassium chloride of 20 mmol was given over one hour followed by a maintenance infusion of 1.6 mmol/h.Her BP was sustained well above systolic 100 and diastolic 60 mmHg one hour after starting the epinephrine drip. At six hours post-overdose, the QRS

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Fatal Hydroxychloroquine Overdose

Fung¹,

Lam²,

Wong³

et al. 2007

Hong Kong j. emerg. med.

View full text Add to dashboard Cite

show abstract

“…However, several reports have suggested that hypokalemia may be protective in severe CQ poisoning. [18][19][20] Therefore, replacement of potassium is controversial in the setting of acute toxicity, although we believe it would be reasonable to treat severe hypokalemia (i.e., < 2 mmol/L). Cases of rebound hyperkalemia have been reported once toxicity resolves; therefore, serial potassium levels should be obtained.…”

Section: Clinical Managementmentioning

confidence: 99%

Brief Review of Chloroquine and Hydroxychloroquine Toxicity and Management

Lebin

LeSaint

2020

WestJEM

View full text Add to dashboard Cite

show abstract

“…A subsequent prospective study of moderately CQ-intoxicated patients did not find a benefit from treatment with diazepam. 9 Furthermore, it remains unclear if the proposed benefit from highdose diazepam in CQ toxicity may be extrapolated to HCQ, and cases of even massive HCQ ingestions report good outcomes without the use of high-dose diazepam. 10 How aggressively should hypokalemia in hydroxychloroquine toxicity be treated?…”

Section: What Are the Treatment Modalities For Patients With Hydroxycmentioning

confidence: 99%