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[Fenfluramin (ponderax) intoxications in children (author's transl)]
Insights
Accidental fenfluramine poisoning in children can cause severe symptoms like excitation and coma. Prompt medical intervention, including gastric lavage and supportive care, is crucial for managing fenfluramine toxicity.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
Background:
- Fenfluramine, a stimulant, poses a risk of accidental poisoning in children.
- Understanding the clinical manifestations and toxic doses is vital for effective management.
Observation:
- Four pediatric cases of fenfluramine poisoning presented with excitation, coma, convulsions, tachycardia, mydriasis, nystagmus, and facial rubeosis.
- Symptoms appeared within 30-60 minutes post-ingestion and persisted for days.
- Severe trismus necessitated muscle relaxants prior to intubation and gastric lavage in two cases.
Findings:
- Toxic doses are below 5 mg/kg; 5-10 mg/kg can induce coma and convulsions.
- Lethal doses identified were 28.7 and 33.3 mg/kg.
- Clinical signs are consistent with existing poisoning control center data and literature.
Implications:
- Early gastric lavage, continuous vital function monitoring, and prompt administration of anticonvulsants, beta-blockers, lidocaine, or chlorpromazine are essential.
- Artificial ventilation and cardiac defibrillation may be required in severe cases.
- This case series highlights the importance of rapid diagnosis and aggressive supportive care in pediatric fenfluramine poisoning.
Abstract:
4 cases of accidental fenfluramine poisoning in children are reported. Excitation, coma, convulsions, tachycardia, mydriasis, nystagmus, and rubeosis of the face were the most important signs. They appeared 30--60 min after ingestion, and some of them lasted for several days. 2 children had severe trismus and therefore had to be given muscle relaxants before intubation and gastric lavage became possible. These observations agree well with informations collected in our poisoning control center and with previously published data. Less than 5 mg/kg of body weight are toxic, 5--10 mg/kg may produce coma and convulsions, and the smallest lethal doses were 28,7 and 33,3 mg/kg. Early gastric lavage, good monitoring of the vital functions and, if necessary, administration of anticonvulsive drugs, beta-blocking agents, lidocaine, chlorpromazine, and artificial ventilation and cardiac defibrillation are the most important therapeutical measures.