Fatal Self-poisoning with Benoxaprofen

Fancourt, G.J.; Adams, Heather; Walls, John; Ward, John W.

doi:10.1177/096032718400300608

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Oliguria which was not responsive to sodium chloride, furosemide, and mannitol was seen after ingestion of an unknown amount of benoxaprofen by an adult (Fancourt et al 1984). Oliguria which was not responsive to sodium chloride, furosemide, and mannitol was seen after ingestion of an unknown amount of benoxaprofen by an adult (Fancourt et al 1984).…”

Section: Clinical Effects In Overdosementioning

confidence: 94%

“…Fancourt et al (1984) reported that paroxysmal coarse muscle fibrillation and muscle spasms were seen 40 hours after an unknown amount was ingested by a 53-year-old patient. Fancourt et al (1984) reported that paroxysmal coarse muscle fibrillation and muscle spasms were seen 40 hours after an unknown amount was ingested by a 53-year-old patient.…”

Section: Clinical Effects In Overdosementioning

confidence: 99%

“…A pacing catheter was inserted, but the patient died 4 days after ingestion in ventricular fibrillation (Fancourt et al 1984). She was admitted to hospital 24 hours after ingestion with no abnormal findings.…”

Section: Case Reportmentioning

confidence: 99%

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Toxic Effects of Nonsteroidal Anti-Inflammatory Drugs in Overdose

et al. 1990

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Nonsalicylate, nonsteroidal anti-inflammatory drugs (NSAIDs) can be divided into 4 chemical classes: acetic acids, fenamic acids, oxicams and propionic acids. Most NSAID overdoses result in a benign outcome. Of 50,614 exposures reported to poison centres in the United States in a 2-year period, 131 (0.26%) had a major outcome, with 10 deaths. Despite the generally mild effects reported in large patient series, isolated case reports have documented serious toxicity, such as seizures, hypotension, apnoea, coma and renal failure. The majority of these consequences occur after ingestion of substantial quantities by adults attempting suicide. Rarely, with ibuprofen and piroxicam, children who ingest small amounts in accidental exposure develop serious toxicity. Typical signs and symptoms of NSAID overdose include nausea, vomiting, headache, drowsiness, blurred vision and dizziness. Seizures are rarely documented across all NSAID classes, with the exception of mefenamic acid (where seizures occur in over one-third of cases), or following massive ingestion of other agents. Drugs in the propionic acid group have produced metabolic acidosis, respiratory depression and coma in severe cases. Ibuprofen is the agent with the most published data on overdose, probably because it is available without a prescription in many countries. Symptoms are unlikely after ingestion of 100 mg/kg or less, and are usually not life-threatening unless more than 400 mg/kg is ingested. There is some relationship between plasma concentrations and the potential for development of symptoms, but plasma concentrations have no impact on treatment decisions. Treatment of NSAID overdose is entirely supportive. Recent trends in emergency department procedures regarding gastric decontamination are evolving towards the recommended administration of activated charcoal without gastric emptying in patients presenting more than 1 hour after ingestion, although gastric lavage, followed by administration of activated charcoal, may be advisable in patients who present earlier. Home administration of syrup of ipecac is still recommended if treatment is given shortly after ingestion, with a few exceptions: for example, ipecac is contraindicated after ingestion of mefenamic acid or ibuprofen in amounts greater than 400 mg/kg. Urine alkalinisation and diuresis have been recommended to enhance the elimination of NSAIDs, based on a pKa in the range of 3 to 5. However, because the drugs are universally highly protein bound, with little unchanged renal excretion, this technique is not likely to be beneficial. Haemodialysis is also unlikely to enhance elimination, but may be required if oliguric renal failure develops. Multiple dose activated charcoal may be useful in enhancing elimination of NSAIDs with long half-lives, such as piroxicam and sulindac.

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Section: Clinical Effects In Overdosementioning

confidence: 94%

Section: Clinical Effects In Overdosementioning

confidence: 99%

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Toxic Effects of Nonsteroidal Anti-Inflammatory Drugs in Overdose

et al. 1990

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Anti-inflammatory analgesics and drugs used in rheumatoid arthritis and gout

Favero¹

1986

Side Effects of Drugs Annual

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Renal Impairment After Acute Diclofenac, Naproxen, and Sulindac Overdoses

Kulling

Beckman

Skagius

1995

Journal of Toxicology: Clinical Toxicology

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Acute renal dysfunction has been described as a feature of acute overdoses of the nonsteroidal anti-inflammatory drugs benoxaprofen, fenoprofen, ibuprofen, mefenamic acid, piroxicam, suprofen, and zomepirac. The cases reported here include renal impairment after acute overdoses of another three nonsteroidal anti-inflammatory drugs: diclofenac (one case), naproxen (two cases), and sulindac (five cases). The eight patients presented with lumbar pain and oliguria and had protein and erythrocytes in the urine. Serum creatinine was increased to a maximum of 190-932 mumol/L. Renal impairment was generally transient but in one case was treated by hemodialysis and one by continuous arterio-venous hemofiltration dialysis. In all cases of significant acute overdose of nonsteroidal anti-inflammatory drugs, the risk of acute renal dysfunction must be considered.

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Fatal Self-poisoning with Benoxaprofen

Abstract: 1 A report of the first fatal self-poisoning due to primary toxicity of benoxaprofen. 2 Benoxaprofen is toxic in acute overdosage to the central nervous system, myocardium and kidneys, but appears to spare the liver.

Cited by 3 publications

References 9 publications

Toxic Effects of Nonsteroidal Anti-Inflammatory Drugs in Overdose

Toxic Effects of Nonsteroidal Anti-Inflammatory Drugs in Overdose

Anti-inflammatory analgesics and drugs used in rheumatoid arthritis and gout

Renal Impairment After Acute Diclofenac, Naproxen, and Sulindac Overdoses

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