Baclofen intoxication after accidental ingestion in a 3-year-old child

Dasarwar, Nagesh; Shanbag, Preeti; Kumbhare, Nilesh

doi:10.4103/0253-7613.51349

Cited by 11 publications

(18 citation statements)

References 11 publications

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“…The likely causes of baclofen overdose include adaptive and personality disorders as well as depression, leading to suicidal attempts. The literature reports also described cases of accidental consumption of baclofen by children [ 34 – 36 ]. Table 4 lists the cases of baclofen intoxication reported in literature.…”

Section: Resultsmentioning

confidence: 99%

Application of high-resolution mass spectrometry to determination of baclofen in a case of fatal intoxication

et al. 2016

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The study focused on the application of high-resolution mass spectrometry (HRMS) to postmortem toxicological analysis. Fast and simple sample preparation involved precipitation with acetonitrile, removal of phospholipids using special columns and filtration. Qualitative and quantitative analyses were performed using ultra-performance liquid chromatography coupled with quadrupole time-of–flight mass spectrometry. The method was validated by determining the limit of quantification, precision, recovery and matrix effect. The use of a high-resolution spectrometer allowed us to determine the precise masses of the fragments of interest and to suggest the fragmentation pathway of baclofen. The usefulness, effectiveness and assets of the procedure were confirmed by an authentic case of a 25-year-old woman fatally intoxicated with baclofen who was found dead in her apartment. Toxicological analysis of postmortem blood samples demonstrated that the baclofen concentration was 30.7 μg/mL. In only one published case describing fatal baclofen intoxication were no other xenobiotics (that could interact with baclofen) found. To our knowledge, this is the first report dealing with analysis of baclofen by HRMS.

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Section: Resultsmentioning

confidence: 99%

Application of high-resolution mass spectrometry to determination of baclofen in a case of fatal intoxication

et al. 2016

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“…As for all medicines, the survey of baclofen safety must be extended to the family environment, and especially to children. Indeed, 1 case of accidental intoxication was reported in a 3-year-old child [28], and 1 case of deep coma was reported in an adolescent who took baclofen after hearing from a paraplegic friend about the ‘buzz' produced by this molecule [29]. Finally, the last - but not least - point to consider is the problem of under-reporting of adverse drug reactions.…”

Section: Discussionmentioning

confidence: 99%

Death of an Alcohol-Dependent Patient following Intentional Drug Intoxication: Implication of Baclofen?

Pape¹,

Roman²,

Scala‐Bertola³

et al. 2014

Eur Addict Res

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Used in the treatment of spasticity at low doses, baclofen is also prescribed off-label at high doses for the treatment of alcohol dependence. Several cases of baclofen intoxication have been reported, but only 1 case deals with the treatment of alcohol dependence. Thus, we report the first death in the context of baclofen off-label use of an alcohol-dependent patient with a high blood baclofen concentration after intentional drug intoxication. The safety profile of baclofen in the treatment of alcohol dependence is reviewed and discussed, underlining the obligatory caution that may support any prescription of high doses of baclofen in this off-label indication and especially in patients with concomitant psychiatric disorders.

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“… 3 - 5 In one study, baclofen overdose was treated with gastric lavage, vigorous hydration, and forced alkaline diuresis. 3 Elsewhere, hemodialysis therapy was administered to a pediatric patient with acute kidney injury. 6…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Baclofen Toxicity in a Pediatric Patient With Normal Kidney Function Successfully Treated With Hemodialysis

Shah

Kwon

Potter

2020

Can J Kidney Health Dis

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Rationale: Baclofen is a commonly prescribed medication used to decrease spasticity in children with cerebral palsy. Despite its widespread use, this medication has not demonstrated to be consistently effective in clinical studies. Baclofen is also associated with systemic adverse effects due to potent neuronal depression. The management of baclofen toxicity is mainly supportive; however, some studies have shown that hemodialysis may alleviate the symptoms of an overdose and shorten the recovery time. Presenting concerns: In this case report, a 6-year-old boy with mild cerebral palsy, neuromyelitis optica, and normal kidney function was found unresponsive at home, with altered mental status, after ingesting 1300 mg of baclofen unobserved. The patient was intubated and mechanically ventilated because of significant neurologic depression with subsequent respiratory failure. Diagnosis: The patient was diagnosed with baclofen-induced encephalopathy. An elevated serum baclofen level of 4.00 µg/mL (therapeutic range of 0.08-0.40 µg/mL) was observed 10 hours after he was found unresponsive. The patient’s respiratory status deteriorated; he had high ventilatory requirements and remained comatose. Intervention: With the worsening of his clinical condition in the intensive care unit, hemodialysis, administered via a high-efficiency high-flux dialyzer, was initiated approximately 18 hours after he was found unresponsive. The patient underwent 2 hemodialysis runs spaced 9 hours apart, with blood flow rates approaching 250 mL/min. Outcomes: Within 3 hours of the first hemodialysis treatment, the patient started to regain consciousness. He was extubated to room air 6 hours after the second hemodialysis treatment. Novel findings: Supportive management is the primary treatment of baclofen toxicity in a pediatric patient with normal kidney function. Hemodialysis may be considered in severe cases of baclofen toxicity and worsening clinical status, but further studies are needed to confirm this finding.

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Baclofen intoxication after accidental ingestion in a 3-year-old child

Cited by 11 publications

References 11 publications

Application of high-resolution mass spectrometry to determination of baclofen in a case of fatal intoxication

Application of high-resolution mass spectrometry to determination of baclofen in a case of fatal intoxication

Death of an Alcohol-Dependent Patient following Intentional Drug Intoxication: Implication of Baclofen?

A Case Report of Baclofen Toxicity in a Pediatric Patient With Normal Kidney Function Successfully Treated With Hemodialysis

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