T48.6 + (X44.99/X64.99/Y14.99)
DESCRIPTION
Patients present with:
- tachycardia and tachyarrhythmias
- hyperventilation
- nausea and vomiting
- tremor
- agitation
- profound hypokalaemia
- seizures
GENERAL MEASURES
Monitor ECG and treat dysrhythmias.
Monitor and correct fluid status and electrolyte abnormalities.
Monitor theophylline concentrations, if available. Levels may continue to rise up to 24 hours after ingestion of modified release preparations.
MEDICINE TREATMENT
Vomiting is common: (R11)
- Metoclopramide, IV/oral, 10 mg 8 hourly as required.
- Activated charcoal.
- Multiple doses of activated charcoal enhance elimination.
Correct hypokalaemia cautiously:
E87.6 + (T48.6/X44.99/X64.99/Y14.99)
- Potassium chloride, IV, maximal dose 40 mmol/L and maximal rate of 20 mmol/hour.
For seizures: R56.8 + (T48.6/X44.99/X64.99/Y14.99)
Treat with benzodiazepines - see Status epilepticus .
Note: Phenytoin should be avoided (due to potential cardiotoxicity).
REFERRAL
In patients with symptoms of severe overdose (severe hypokalaemia, seizures, refractory hypotension, dysrhythmias, theophylline level >555 micromol/L (100 mg/L), refer for haemodialysis.