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Related Experiment Videos

Dextromethorphan poisoning reversed by naloxone.

S M Schneider1, E A Michelson, C D Boucek

  • 1Department of Medicine, Montefiore Hospital, University of Pittsburgh, PA 15213.

The American Journal of Emergency Medicine
|May 1, 1991
PubMed
Summary

Dextromethorphan overdose can cause respiratory failure. Higher doses of naloxone (0.4mg+) may be needed to reverse severe symptoms in patients with suspected dextromethorphan toxicity.

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Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Dextromethorphan is a common cough suppressant found in many over-the-counter medications.
  • Dextromethorphan toxicity is rarely reported, especially cases involving severe respiratory depression.
  • Asthma is a pre-existing condition that may influence the presentation and management of dextromethorphan toxicity.

Purpose of the Study:

  • To report an unusual case of severe dextromethorphan toxicity.
  • To highlight the potential need for higher or repeated doses of naloxone in managing dextromethorphan overdose.
  • To provide guidance on the administration of naloxone for suspected dextromethorphan-induced respiratory failure.

Main Methods:

  • Case report of a patient with asthma presenting with somnolence and respiratory failure.

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  • Administration of naloxone (1 mg initially, followed by additional doses).
  • Clinical assessment of patient's response to naloxone treatment.

    • Main Results:

    • The patient presented with symptoms suggestive of end-stage respiratory failure.
    • Initial low-dose naloxone (1 mg) provided only partial improvement.
    • Additional doses of naloxone were required to achieve complete normalization of mental status.
    • The case underscores the potential for significant respiratory depression from dextromethorphan.

    Conclusions:

    • Dextromethorphan overdose can lead to severe respiratory compromise, even in patients without a history of substance abuse.
    • Standard naloxone dosing may be insufficient for reversing severe dextromethorphan toxicity.
    • Intravenous administration of 0.4 mg or more of naloxone is recommended for suspected dextromethorphan overdose presenting with respiratory failure.