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Rapid death resulting from mesoridazine overdose.
Veterinary and Human Toxicology
|February 1, 1987
Summary
This case report details a fatal mesoridazine overdose in a young woman. Aggressive treatment and close monitoring are crucial for managing severe phenothiazine overdoses due to rapid decline.
Area of Science:
- Clinical Toxicology
- Cardiovascular Pharmacology
- Emergency Medicine
Background:
- Phenothiazine derivatives, like mesoridazine, are antipsychotic medications.
- Overdose cases, particularly fatal ones, require prompt recognition and management.
Observation:
- A 23-year-old woman presented with altered mental status after ingesting mesoridazine.
- Initial treatment included gastric lavage and activated charcoal, but her condition deteriorated.
- She developed severe hypotension, QRS widening, seizures, and refractory ventricular fibrillation.
Findings:
- Antemortem blood mesoridazine levels were significantly elevated at 16 µg/mL.
- The patient experienced rapid clinical deterioration leading to cardiac arrest and death.
- Despite advanced life support, including electrical cardioversion and CPR, resuscitation was unsuccessful.
Implications:
- This case highlights the potential for rapid and fatal outcomes in mesoridazine overdose.
- It underscores the critical need for intensive monitoring and aggressive therapeutic interventions in phenothiazine poisoning.
- Clinicians should be prepared for severe cardiotoxicity and arrhythmias in significant mesoridazine ingestions.