Đăng xuất
Colchicine has a narrow therapeutic window and is highly toxic when overdosed. Patients at high risk of toxicity: kidney failure, liver failure, gastrointestinal diseases, heart disease, patients at extremes of age.
Colchicine overdose should be promptly consulted by a doctor. Toxicity can be delayed up to 6 hours to become apparent, some features of toxicity can be delayed by 1 week or longer.
After a colchicine overdose, all patients, even without initial symptoms, should be medically evaluated immediately.
Symptom: Symptoms of acute overdosage may be delayed (3 hours on average): nausea, vomiting, abdominal pain, hemorrhagic gastroenteritis, volume depletion, electrolyte abnormalities, leukocytosis, hypotension in severe cases.
The second phase with life threatening complications develops 24 to 72 hours after drug administration: multisystem organ dysfunction, acute renal failure, confusion, coma, ascending peripheral motor and sensory neuropathy, myocardial depression, pancytopenia, dysrhythmias, respiratory failure, consumption coagulopathy. Death is usually a result of respiratory depression and cardiovascular collapse. If the patient survives, recovery may be accompanied by rebound leukocytosis and reversible alopecia starting about one week after the initial ingestion.
Treatment: No antidote is available. Therefore, the poison can be removed by gastric lavage within 1 hour after acute poisoning.
Consider oral activated charcoal in adults who have ingested more than 0.1 mg/kg bodyweight within 1 hour of presentation and in children who have ingested any amount within 1 hour of presentation.
Haemodialysis has no efficacy.
Close clinical and biological monitoring in hospital environment.
Symptomatic and supportive treatment: control of respiration, maintenance of blood pressure and circulation, correction of fluid and electrolytes imbalance.
