Article ; Online: Vasopressor therapy in atypical antipsychotic overdose.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
2020 Volume 110, Issue 10, Page(s) 1003–1005
Abstract: Hypotension is a common presentation following an overdose of quetiapine. Adrenaline is often used as the vasopressor of choice for hypotension not responding to intravenous fluids. We present a case of quetiapine overdose with hypotension unresponsive ... ...
| Abstract | Hypotension is a common presentation following an overdose of quetiapine. Adrenaline is often used as the vasopressor of choice for hypotension not responding to intravenous fluids. We present a case of quetiapine overdose with hypotension unresponsive to high-dose adrenaline. The patient was commenced on noradrenaline and made a full recovery. We highlight learning points about vasopressor therapy for atypical antipsychotic overdose. Quetiapine-induced hypotension is thought to be mediated by α1-receptor antagonism. Adrenaline is unlikely to improve blood pressure, as it is an agonist at both α- and β-receptors. Alpha-2- and β2-agonism can reduce sympathetic outflow and cause vasodilation, respectively, further exacerbating the hypotension. Noradrenaline is the preferred vasopressor of choice for hypotension caused by quetiapine overdose, as it has less affinity for α2- and β2-receptors, but maintains α1-receptor agonism. Drugs with a similar mechanism of inducing hypotension should also be treated with noradrenaline as the vasopressor of choice. |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| MeSH term(s) | Antipsychotic Agents/poisoning ; Drug Overdose/drug therapy ; Epinephrine/pharmacology ; Epinephrine/therapeutic use ; Female ; Humans ; Hypotension/chemically induced ; Hypotension/drug therapy ; Norepinephrine/pharmacology ; Norepinephrine/therapeutic use ; Quetiapine Fumarate/poisoning ; Treatment Outcome ; Vasoconstrictor Agents/pharmacology ; Vasoconstrictor Agents/therapeutic use ; Young Adult | ||||||||||
| Chemical Substances | Antipsychotic Agents ; Vasoconstrictor Agents ; Quetiapine Fumarate (2S3PL1B6UJ) ; Norepinephrine (X4W3ENH1CV) ; Epinephrine (YKH834O4BH) | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2020-09-30 | ||||||||||
| Publishing country | South Africa | ||||||||||
| Document type | Case Reports ; Journal Article | ||||||||||
| ZDB-ID | 390968-2 | ||||||||||
| ISSN | 2078-5135 ; 0038-2469 ; 0256-9574 | ||||||||||
| ISSN (online) | 2078-5135 | ||||||||||
| ISSN | 0038-2469 ; 0256-9574 | ||||||||||
| DOI | 10.7196/SAMJ.2020.v110i10.14771 | ||||||||||
| Shelf mark |
|
||||||||||
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Ua VI Zs.406: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
|||
| Zs.MO 645: Show issues |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.