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Upper airway compromise in acute chlorpromazine ingestion
S A Russell1, H M Hennes, K J Herson
1Medical College of Wisconsin, Milwaukee, USA.
The American Journal of Emergency Medicine
|September 1, 1996
Insights
A 16-year-old boy experienced severe breathing difficulties after ingesting chlorpromazine. This case highlights that acute upper airway compromise in children may indicate phenothiazine exposure, a serious condition.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Toxicology
- Pharmacology
Background:
- Phenothiazines, such as chlorpromazine, are antipsychotic medications with potential for overdose.
- Dystonic reactions are extrapyramidal side effects that can affect muscle tone and movement.
- Laryngeal-pharyngeal dystonia is a rare but critical complication of phenothiazine use.
Observation:
- A 16-year-old male presented with acute upper airway compromise.
- The patient had ingested six 100-mg tablets of chlorpromazine (Thorazine).
- Symptoms suggested a severe dystonic reaction affecting the laryngeal and pharyngeal muscles.
Findings:
- Chlorpromazine ingestion led to dose-dependent laryngeal-pharyngeal dystonia.
- This dystonia resulted in life-threatening acute upper airway compromise.
- The case underscores the critical nature of phenothiazine-induced dystonia in pediatric patients.
Implications:
- Clinicians should consider phenothiazine exposure in children presenting with acute upper airway compromise.
- Prompt recognition and management of dystonic reactions are crucial for preventing respiratory failure.
- This case emphasizes the importance of careful medication management and overdose awareness in adolescents.
Abstract:
A 16-year-old boy developed symptoms of acute upper airway compromise after chlorpromazine ingestion. The patient took six 100-mg Thorazine tablets "to help him sleep". Laryngeal-pharyngeal dystonia is a life-threatening form of dystonic reaction that is dose-dependent. In children, acute upper airway compromise should raise the suspicion of exposure to phenothiazines.