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Case Reports
. 2017 Aug;18(3):247-250.
doi: 10.1177/1751143717693860. Epub 2017 Feb 20.

Too many pills to swallow: A case of a mixed overdose

Louise Emily Hopkins  1 , Jonathan Sunkersing  1 , Andrew Jacques  1
Affiliations
Case Reports

Too many pills to swallow: A case of a mixed overdose

Louise Emily Hopkins et al. J Intensive Care Soc. 2017 Aug.

Abstract

Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity - profound hypotension and circulatory collapse, respiratory depression and coma. The patient had conventional therapy but failed to respond to this and was therefore commenced on IntraLipid infusion, high-dose insulin infusion and inotrope infusion. An endoscopy was performed in intensive care which revealed a large drug beozar - this was removed. We believe that this combination of infusions with early endoscopy could be beneficial in treating similar patients in the future and present the first case of a propranolol drug bezoar.

Keywords: Drug overdose; beozar; oesophago-gastro-duodenoscopy; propranolol.

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Figures

Figure 1.
Figure 1.
Drug beozar at OGD.
See this image and copyright information in PMC

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