Treatment of hydroxychloroquine overdose

Massive hydroxychloroquine overdose

“…Hydroxychloroquine poisoning is often characterized by rapid deterioration and cardiovascular collapse because of myocardial depression and ventricular arrhythmias (1-3). Central nervous system and respiratory depression, convulsions, coma, nausea, vomiting, mild to severe hypokalemia, hypotension, widening QRS and QT intervals and ventricular arryhthmias may be seen in a hydroxychloroquine overdose (1)(2)(3)(4). Although the amount of the ingested dose was selfreported and the hydroxychloroquine serum level was not measured, the clinical course of our case was consistent with a severe hydroxychloroquine overdose.…”

“…There have been a few reports on the toxicity of hydroxychloroquine in humans. Our literature search revealed 16 reported cases of hydroxycholoroquine overdose (2)(3)(4)(5). We report a case presenting with a near fatal hydroxychloroquine overdose who survived without any sequelae.…”

Are 1–2 dangerous? Chloroquine and hydroxychloroquine exposure in toddlers

“…Hydroxychloroquine overdoses are rarely reported; a literature search by Marquardt and Albertson revealed only 7 reported acute overdoses, of which only one was in a child less than 6 years old (8). This 2-year-old boy developed seizures, cardiorespiratory arrest, and died after ingesting 12 grams of hydroxychloroquine; postmortem blood concentration of 104 mg/L confirmed a large overdose (48).…”

“…Decline of blood concentrations of chloroquine and its metabolites is rapid during the first days but slows down and after 2 months is markedly prolonged (7). Plasma terminal elimination half-life is 20 -60 days, with both the parent drug and metabolite able to be detected in urine months after a single dose (8). Very little is known of hydroxychloroquine kinetics in overdose except that plasma concentrations fit a twocompartment model with a volume of distribution of 63 L/kg, and a half-life of 15.5 to 31 h (9,10).…”

Physiology of the Developing Kidney: Fluid and Electrolyte Homeostasis and Therapy of Basic Disorders (Na/H2O/K/Acid Base)

“…Since many hypokalemic children have concomitant alkalosis with hypochloremia, potassium chloride is most frequently used for both enteral and intravenous supplementation. Potassium chloride supplements have also been shown to accomplish more efficient repletion than potassium phosphorus or potassium citrate or bicarbonate, although with concomitant acidosis or hypophosphatemia, their provision does make sense [198].…”