Korean Journal of Nephrology 1998;17(2):352-356.
Doxylamine 중독후 합병한 비외상성 횡문근융해증 1예
박성민 , 이준홍 , 성은영 , 강양호 , 임종훈 , 이우철 , 이수봉 , 이창원 , 곽임수 , 나하연
Abstract
Because doxylamine is an antihistamine commonly used as over-the counter sleep preparation, it may bring out overdose. The usual clinical course of the overdose is dominated by the anticholinergic effect of these agents', it include significant autonomic and central nervous system effect. The most frequent symptom included impaired consciousness, seizure, tachycardia, mydriasis and a psychosis similar to that in catatonic stupor, A serious complications may be rhadbomyolysis with subsequent impairment of renal function and acute renal failure. Though the exact mechaism is not clear yet, it seems likely that doxylamine has a direct toxic effect on striated muscle. We report a case of a 22-year-old man who was complicated by rhabdomyolysis and impairment of renal function after doxylamine overdose. He was transported due to reddish urine from other hospital. According to transfer note, when he arrived at emergency room, he had slight drowsy mental state without tonic clonic seizure. He developed a elevated muslce enzyme and showed generalized, multiple uptake in damages muscle with the image of Tc-MDP bone scan. He was managed with hyd- ration, urine alkalinization and supportive care during hospitalization. If doxylamine overdose are suspected, we should obtain creatine kinase level. Recognition of the pote- ntial for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug.
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