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Acute acepromazine overdose: clinical effects and toxicokinetic evaluation
D Adam Algren1, Amber Ashworth
1Division of Clinical Pharmacology/Medical Toxicology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA, Adam.Algren@tmcmed.org.
This case report details a rare human overdose of acepromazine, a veterinary drug. The patient experienced central nervous system and cardiovascular toxicity but rapidly improved within 8 hours, suggesting a short elimination half-life.
Area of Science:
- Veterinary Pharmacology
- Clinical Toxicology
- Pharmacokinetics
Background:
- Acepromazine, a phenothiazine, is exclusively used in veterinary medicine.
- Human overdose data and toxicokinetic information for acepromazine are scarce.
- This study presents a case of intentional acepromazine overdose in a human.
Observation:
- A 54-year-old woman ingested 950 mg of acepromazine.
- She developed central nervous system and respiratory depression, and hypotension within 3 hours.
- Supportive care included non-invasive ventilation and vasopressors.
Findings:
- Serial plasma acepromazine levels were measured using gas chromatography/mass spectrometry.
- Initial acepromazine level was 63 ng/ml at 1 hour post-ingestion.
- Toxicity resolved within 8 hours, with plasma levels decreasing significantly.
Implications:
- Human acepromazine toxicity presents with CNS and cardiovascular effects similar to other phenothiazines.
- Acepromazine appears to have a short elimination half-life in humans, leading to rapid clinical improvement.
- Supportive care is the primary treatment for acepromazine overdose.
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