Acute pancreatitis following naproxen intake

Aygencel, Gülbin; Akbuga, Betul; Keleş, Ayfer

doi:10.1097/01.mej.0000224428.51623.b2

Cited by 13 publications

(4 citation statements)

References 1 publication

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“…Ibuprofen has been reported to cause hepatitis as well as fulminant liver failure requiring transplant [10,11]. Pancreatitis has also been reported after naproxen overdose and with therapeutic use, but our patient's amylase was normal [12,13]. The transaminitis noted on presentation was treated empirically with IV N-acetylcysteine as a prudent step in case of unreported prior acetaminophen ingestion.…”

Section: Discussionmentioning

confidence: 78%

Massive Naproxen Overdose with Serial Serum Levels

et al. 2014

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Context Massive naproxen overdose is not commonly reported. Severe metabolic acidosis and seizure have been described, but the use of renal replacement therapy has not been studied in the context of overdose. Case Details A 28-year-old man ingested 70 g of naproxen along with an unknown amount of alcohol in a suicidal attempt. On examination in the emergency department 90 min later, he was drowsy but had normal vital signs apart from sinus tachycardia. Serum naproxen level 90 min after ingestion was 1,580 mg/L (therapeutic range 25-75 mg/L). He developed metabolic acidosis requiring renal replacement therapy using sustained low efficiency dialysis (SLED) and continuous venovenous hemofiltration (CVVH) and had recurrent seizure activity requiring intubation within 4 h from ingestion. He recovered after 48 h. Discussion Massive naproxen overdose can present with serious toxicity including seizures, altered mental status, and metabolic acidosis. Conclusion Hemodialysis and renal replacement therapy may correct the acid base disturbance and provide support in cases of renal impairment in context of naproxen overdose, but further studies are needed to determine the extraction of naproxen.

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Section: Discussionmentioning

confidence: 78%

Massive Naproxen Overdose with Serial Serum Levels

et al. 2014

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“…Naproxen does not belong to the most frequently prescribed NSAIDs, and cases of poisoning are rarely reported in the literature . Among documented cases, there are two documented reported cases without any naproxen blood concentration data: a report of kidney failure and another acute pancreatitis, both of which lacked the plasma concentration of naproxen. Al‐Abri et al recently published a case of a 28‐year‐old man who ingested 320 tablets of naproxen in 220‐mg doses (or 70.4 g).…”

Section: Discussionmentioning

confidence: 99%

Severe poisoning with naproxen causing coagulopathy

Lelièvre

Drouillard²,

Thill³

et al. 2019

Basic Clin Pharma Tox

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Non-steroidal anti-inflammatory drugs (NSAIDs) are well known for their most frequent side effects (digestive, renal and metabolic disorders) but are lesser known for other effects, such as coagulation disturbances. In this issue, we report the case of a 58-year-old woman who ingested 26 g of naproxen in a suicidal attempt and developed cardiovascular shock, hypocoagulability and thrombopenia. Her outcome was positive (extubation 3 days after admission [D3], correction of haemostatic disruptions on D5 and of thrombopenia on D6). Naproxen plasma concentration was at a toxic concentration of 1320 mg/L at 6 hours after drug ingestion. Only few cases of hypocoagulopathy are reported with the NSAIDs, and this is the first case that can be attributed to naproxen. A possible explanation of this phenomenon following naproxen ingestion is an inhibition of thromboxane A2, usually attributed to NSAIDs, combined with an inhibition of activation of downstream the cascade. K E Y W O R D S hypocoagulopathy, naproxen, thrombopenia, thromboxane A2 How to cite this article: Lelièvre B, Drouillard I, Thill C, et al. Severe poisoning with naproxen causing coagulopathy.

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“…The investigators independently screened all articles for those that met broad inclusion criteria. A total of 92 citations were found [1,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,…”

Section: Literature Searchmentioning

confidence: 99%

“…There is also a lack of evidence regarding the degree of efficacy of the various pharmacological substances used to treat the different forms of acute pancreatitis. On the other hand, there are several reports concerning the possibility that non-steroidal anti-inflammatory drugs (NSAIDs) may actually induce acute pancreatitis [5,6,7,8,9,10,11,12,13,14,15,16,17]. NSAIDs have also been used to prevent retrograde endoscopic cholangiopancreatography (ERCP)-induced acute pancreatitis [18].…”

Section: Introductionmentioning

confidence: 99%

NSAIDs and Acute Pancreatitis: A Systematic Review

2010

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The resulting pain is the main symptom of acute pancreatitis and it should be alleviated as soon as possible. NSAIDs are the first line therapy for pain and they are generally administered to acute pancreatitis patients upon admission to the hospital. In addition, these drugs have also been used to prevent post-endoscopic cholangiopancreatography (ERCP) acute pancreatitis. On the other hand, there are several reports indicating that NSAIDs may be the actual cause of acute pancreatitis. We carried out a literature search on PubMed/MEDLINE; all full text papers published in from January 1966 to November 2009 on the use of NSAIDs in acute pancreatitis were collected; the literature search was also supplemented by a review of the bibliographies of the papers evaluated. Thus, in this article, we will systematically review the current literature in order to better illustrate the role of NSAIDs in acute pancreatitis, in particular: i) NSAIDs as a cause of acute pancreatitis; ii) their use to prevent post-retrograde ERCP pancreatitis and iii) their efficacy for pain relief in the acute illness of the pancreas.

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Acute pancreatitis following naproxen intake

Cited by 13 publications

References 1 publication

Massive Naproxen Overdose with Serial Serum Levels

Massive Naproxen Overdose with Serial Serum Levels

Severe poisoning with naproxen causing coagulopathy

NSAIDs and Acute Pancreatitis: A Systematic Review

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