The Poison Lab
Mini Episode: Managing Crashing Hydroxychloroquine/Chloroquine OD
Episode Summary
In this episode, Ryan breaks down the potential toxicities and unique treatments for hydroxychloroquine and chloroquine overdose
Episode Notes
Quick review
- Toxic dose
- Chloroquine >5g severe toxicity is expected (toxicity may develop below this)
- HCQ less well defind
- Clinical effects
- Seizures (sodium channel blockade)
- Arrhythmia (sodium channel blockade)
- Hypotension (Alpha blockade)
- Hypokalemia
- Management
- Activated Charcoal if awake and alert and no risk of emesis
- Early invasive supportive care based on the following retrospective case control series https://www.nejm.org/doi/full/10.1056/NEJM198801073180101
- High dose epinephrine (0.25 mcg/kg/min)
- Diazepam 1-2 mg/kg over 30 minutes followed by 1-2 mg/kg over 24 hours (seizure prevention)
- Evidence supports this may be cardio protective as well
- Early intubation
- Consultation with poison center recommended 1-800-222-1222