A 53-year-old woman with a suspected drug overdose

Austin et al asserts that a 53-year-old woman was brought to the emergency department after being found unresponsive at home, surrounded by empty pill bottles. Her partner had spoken to her on the phone 5 hours earlier, when she was reportedly well. Her medical history included bipolar I disorder an...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2022-02, Vol.194 (5), p.E163-E166
Main Authors: Kobylianskii, Jane, Austin, Emily, Kumachev, Alexander, Wu, Peter E
Format: Article
Language:English
Subjects:
Acids
Alcohol
Analgesics
Anesthesia
Case reports
Charcoal
Coma
Consciousness
Dehydrogenases
Delirium
Diagnosis, Differential
Drug overdose
Drug Overdose - diagnosis
Drugs
Electrocardiography
Electrolytes
Emergency medical care
Emergency Service, Hospital
Ethanol
Female
Glasgow Coma Scale
Glucose
Hemodialysis
Humans
Immunoassay
Metabolism
Metabolites
Middle Aged
Narcotics
Nervous system
Overdose
Poisoning
Practice
Serotonin
Suicide, Attempted
Suicides & suicide attempts
Toxicity
Urine
Womens health
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Summary:Austin et al asserts that a 53-year-old woman was brought to the emergency department after being found unresponsive at home, surrounded by empty pill bottles. Her partner had spoken to her on the phone 5 hours earlier, when she was reportedly well. Her medical history included bipolar I disorder and 2 previous suicide attempts. History from her partner raised concern that she may have ingested about ninety 0.5-mg tabs of lorazepam, seventy 1-mg tabs of alprazolam, forty-eight 1-mg tabs of clonazepam, twenty-four 50-mg tabs of quetiapine, ten 7.5-mg tabs of zopiclone and 1 bottle of NyQuil, which contains acetaminophen, dextromethorphan and doxylamine. Poisoning in patients is common and poses diagnostic and management challenges. Given the unpredictable nature of drug overdoses and poisonings, conducting randomized controlled trials is seldom practical; therefore, much of the evidence in toxicology relies on case series, animal models and expert opinion. Propylene glycol is a diluent alcohol in many pharmaceuticals, foods and cosmetics.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.211620