Clin-Alert®Pub Date : 2017-07-01DOI: 10.1177/0069477017723600
T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"T. Mcevoy","doi":"10.1177/0069477017723600","DOIUrl":"https://doi.org/10.1177/0069477017723600","url":null,"abstract":"A 64-year-old male patient developed progressive cramping abdominal pain, malaise, nausea, and vomiting approximately 5 months after selfstarting 7 herbal medications for the treatment of diabetes. The only other concurrent medication noted in the report was saxagliptin. Examination revealed elevated blood pressure and abdominal pain with no guarding. Abnormal laboratory values indicated hypochromic normocytic anemia and mild renal dysfunction. Blood lead levels were 6.8 mmol/L. The herbal medications were analyzed revealing lead content that would have resulted in total lead exposure of 52.84 mg/day and a cumulative total lead exposure of 9.64 g. Oral chelation therapy was initiated with dimercaptosuccinic acid (10 mg/kg 3 times a day for 5 days and then twice a day for 2 weeks). The patient was discharged with follow-up monitoring. After treatment with a total of 2 courses of dimercaptosuccinic acid (19 days each), the blood lead level decreased to 1.4 mmol/L. The authors concluded that this patient experienced lead poisoning as a result of exposure from herbal medications. Ayurvedic Medications [Herbal Medications] Sadler M & Bell S (M Sadler, PO Box 105-952, Auckland City 1143, New Zealand; e-mail: matthew.sadler@doctors.net.uk) Ayurvedic plumbism. Intern Med J 47:823–825 (Jul) 2017","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126450344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clin-Alert®Pub Date : 2017-05-01DOI: 10.1177/0069477017709979
T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"T. Mcevoy","doi":"10.1177/0069477017709979","DOIUrl":"https://doi.org/10.1177/0069477017709979","url":null,"abstract":"A 41-year-old male schizophrenic patient developed hypothermia after receiving 2 doses of zotepine (total dose: 150 mg) on hospitalization. Prior to admission, the patient had been receiving flupentixol (12 mg/day), which was stopped due to lack of therapeutic benefit. On admission, his body temperature was 36.4°C, but reduced to 34°C after receiving 2 doses of zotepine. Additional symptoms included sinus bradycardia (52 beats per minute), hypotension (97/66 mm Hg), and a Glasgow Coma Scale score of 3. Laboratory screenings and a computed tomography scan of the brain did not reveal a specific cause. Treatment included transfer to an intensive care unit and the discontinuation of zotepine. Over a 9-day period in the intensive care unit setting, the patient’s status and body temperature gradually recovered. A switch in medication to amisulpride (800 mg/day) and olanzapine (20 mg/day) on separate occasions was not helpful. However, the patient did respond to clozapine (200 mg/day). The remainder of his hospital stay was uneventful, and the patient was eventually discharged to the long-term care facility that he resided in prior to admission. The authors concluded that this patient experienced drug-induced hypothermia related to zotepine based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. They encouraged clinicians to be aware of hypothermia associated with antipsychotics including zotepine and that body temperatures should be monitored in patients with schizophrenia. Zotepine [“Losizopilon,” “Lodopin,” “Setous,” “Zoleptil”] Chen TR et al (WC Ouyang, Department of Psychiatry, Changhua Christian Healthcare System and Changhua Christian Hospital, Changhua, Taiwan; e-mail: d88904@gmail.com) Zotepine-associated hypothermia in a schizophrenic inpatient. J Clin Psychopharmacol 37:367–368 (Jun) 2017","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134266116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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