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[A case of minoxidil intoxication].
Chudoku Kenkyu : Chudoku Kenkyukai Jun Kikanshi = the Japanese Journal of Toxicology
|August 17, 2016
Summary
Minoxidil overdose in a suicidal attempt led to shock and delayed heart failure. Prompt fluid resuscitation improved circulation, but excessive fluids caused heart failure, requiring mechanical ventilation and vasopressors.
Area of Science:
- Cardiology
- Toxicology
- Emergency Medicine
Background:
- Minoxidil, an over-the-counter medication, is primarily used for hypertension and hair loss.
- Oral minoxidil overdose can lead to severe cardiovascular toxicity.
Observation:
- A 26-year-old male presented with shock (hypotension, tachycardia) after ingesting 120 mL of minoxidil solution (60g total dose).
- Initial management with intravenous fluids improved hemodynamic status.
- Delayed heart failure developed 40 hours post-ingestion, attributed to excessive fluid resuscitation and impaired vascular function.
Findings:
- The patient required mechanical ventilation and noradrenaline for circulatory support due to heart failure.
- Cardiovascular compromise persisted for over 100 hours.
- Complete recovery was achieved with supportive care, and the patient was discharged on the 9th hospital day.
Implications:
- Emergency physicians must recognize the potential for severe cardiovascular toxicity from oral minoxidil ingestion.
- Careful fluid management is crucial to prevent complications like heart failure in minoxidil overdose.
- Awareness of minoxidil's toxicity is vital given its accessibility.