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Hypocalcemia and hypomagnesemia after ibuprofen overdose
N N al-Harbi1, S Domrongkitchaiporn, D S Lirenman
1College of Medicine, King Saud University-Abha Branch, Saudi Arabia.
The Annals of Pharmacotherapy
|April 1, 1997
Summary
Ibuprofen overdose can cause hypocalcemia and hypomagnesemia, leading to seizures in children. Prompt electrolyte replacement is crucial for managing these severe adverse events.
Area of Science:
- Pediatric toxicology
- Clinical pharmacology
- Emergency medicine
Background:
- Ibuprofen is a common nonsteroidal anti-inflammatory drug (NSAID) used for pain and fever.
- Overdose can lead to serious complications, including acute kidney injury and metabolic disturbances.
- Electrolyte imbalances are a potential, though rarely reported, consequence of severe ibuprofen toxicity.
Observation:
- A 21-month-old boy ingested 8 grams of ibuprofen, resulting in acute renal failure and metabolic acidosis.
- The child subsequently experienced tonic-clonic seizures 46 hours post-ingestion.
- Laboratory findings revealed significant hypocalcemia and hypomagnesemia coinciding with the seizures.
Findings:
- This case highlights a potential link between ibuprofen overdose and severe hypocalcemia and hypomagnesemia.
- Seizures in this context appear to be associated with deficiencies in serum calcium and magnesium.
- The concurrent use of sodium polystyrene sulfonate and furosemide may have exacerbated the electrolyte disturbances.
Implications:
- Healthcare providers should consider monitoring serum calcium and magnesium levels in pediatric patients with ibuprofen overdose, especially if seizures occur.
- Early identification and management of hypocalcemia and hypomagnesemia with electrolyte supplementation are vital.
- Avoidance of furosemide in ibuprofen overdose cases may be prudent to prevent worsening of electrolyte imbalances.