PP232—Acute toxicity profile of pipamperone in overdose: A consecutive case series
Abstract
e92 Volume 35 Number 8S Results: Of 152,762 reports to STIC, 55 involved OD with thiopurines (n = 39), MMF (n = 14), or SIR (n = 2). Of these, 32 were with suicidal intent, 19 accidental, and 4 iatrogenic errors. Eleven (31%) thiopurine, 4 (31%) MMF, and 1 (50%) SIR ODs had attributable symptoms. The majority of symptoms were minor, although 1 case of sustained thiopurine OD caused agranulocytosis, 1 case of a 9-fold MMF OD caused biphasic hypotension (possibly reflecting enterohepatic circulation), and 1 case of SIR OD in a child caused tremor, raised liver enzymes, and gastroenteritis. Symptoms were observed in patients taking 1.5 and 2.4 times or greater than their usual dose (or the maximum licensed dose in patients not usually taking medication) for thiopurines and MMF, respectively. Decontamination measures were undertaken in 10 thiopurine ODs (9 activated charcoal, 1 gastric lavage). The OR for the development of symptoms after gastrointestinal decontamination in these ODs was 0.14 (95% CI, 0.01–1.5) compared with cases without decontamination. Charcoal was given primarily to children. The mean age of cases managed with charcoal was 8 (10) versus 30 (15) years for cases managed without (P < 0.0001). Conclusion: Acute toxicity with thiopurines appears to only be significant with a prolonged exposure to high drug concentrations. MMF ODs seem to be well tolerated. Physicians should be aware, however, that patients who develop hypotension shortly after oral OD may relapse…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 39 participants or records.
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