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This article from Reactions Weekly discusses four case reports of patients who experienced various toxicities after overdosing on chlorpromazine. The study included 218 adult patients who were admitted and enrolled after ingesting an overdose of chlorpromazine. Three of the patients developed seizures, while one patient experienced cardiac arrest and ultimately died from ischaemic heart disease. The article highlights the potential risks and complications associated with chlorpromazine overdose. [Extracted from the article]

A 54-year-old woman with metastatic leiomyosarcoma developed ifosfamide neurotoxicity during treatment. She also experienced serotonin toxicity after taking methylthioninium-chloride for the neurotoxicity and fluoxetine. The woman had a history of metastatic leiomyosarcoma and was receiving bupropion and fluoxetine. After starting high-dose ifosfamide, she developed neurotoxicity symptoms, leading to the discontinuation of further chemotherapy. Treatment with methylthioninium-chloride resulted in the development of serotonin toxicity, which was successfully treated with cyproheptadine. The woman eventually recovered and returned to her baseline condition. [Extracted from the article]

A retrospective cohort study was conducted on 13 adult patients who experienced QRS complex widening after overdosing on bupropion, a medication used for various indications. The patients ingested different dosages of bupropion, with some also co-ingesting other substances. Following the overdose, all patients required hospital admission due to QRS complex prolongation, and they were treated with sodium-bicarbonate. The study provides information on the occurrence of QRS complex widening as a result of bupropion overdose. [Extracted from the article]

A 76-year-old man with a history of depression, hypertension, and atrial fibrillation accidentally consumed an agricultural surfactant called Wetter 600. He was admitted to the hospital and experienced symptoms such as tachycardia, syncopal episode, hypotension, and metabolic and respiratory acidosis. Despite receiving treatment with atropine, amiodarone, and norepinephrine, his condition worsened and he eventually went into cardiac arrest and died. The lack of efficacy of these medications in his case was noted. [Extracted from the article]

A 70-year-old woman with stage 5 chronic kidney disease and a liver transplant developed neurotoxicity while being treated with valaciclovir for a varicella zoster virus infection. She experienced acute confusion, bilateral asterixis, expressive aphasia, and myoclonus. The woman was diagnosed with neurotoxicity induced by valaciclovir and was treated with dialysis, which resulted in improvement and no recurrent neurological deficits. She was also found positive for varicella zoster virus and received treatment with ganciclovir and valaciclovir. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is: Drug overdose• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventAn eight-day-old boy had analgesic drug level increased due to accidental paracetamol overdose following incorrect dose administration. [Extracted from the article]

Initial laboratory findings (at current presentation) showed valproic-acid concentration of 236.5 µg/mL and ammonia of 154 µmol/L. Consultation with the local poison centre recommended serial laboratory analyses. Initial laboratory findings revealed valproic-acid concentration of 616.8 µg/mL and ammonia of 199 µmol/L. Consultation with the local poison centre recommended serial laboratory analyses. Second dose of ertapenem was administered following second valproic-acid concentration peak after 2 days of the initial presentation; thereafter, the valproic-acid concentration reduced further to 119.2 µg/mL with ertapenem. [Extracted from the article]

Patient 3: A patient was admitted to hospital following IV paracetamol [acetaminophen] overdose. Patient 2: A patient was admitted to hospital following IV paracetamol [acetaminophen] overdose 1000mg. Patient 1: A patient was admitted to hospital following IV paracetamol [acetaminophen] overdose 1000mg (78 mg/kg). [Extracted from the article]

He was noted with supraventricular tachycardia and was treated with adenosine and IV metoprolol; however, he was reported to be resistant to them (lack of efficacy with adenosine and metoprolol). It was concluded that his brady-asystolic cardiac arrest was caused by diltiazem overdose due to wrongful administration of 20mL diltiazem instead of 20mg. [Extracted from the article]

Case 1: The adult patient developed severe status epilepticus after intentional ingestion of promazine 2500mg at an intentional overdose. Case 2: The adult patient developed severe hypotonia after intentional ingestion of promazine 2500mg at an intentional overdose. [Extracted from the article]