When COVID-19 prophylaxis leads to hydroxychloroquine poisoning

  • Matthew Cohen Department of Emergency Medicine, Carl R. Darnall Army Medical Center, Fort Hood, TX https://orcid.org/0000-0002-7100-2869
  • Tyler Miklovic Department of Emergency Medicine, Carl R. Darnall Army Medical Center, Fort Hood, TX
  • Nathan Lott Medical Intensive Care Unit, Baylor Scott and White, Waco, TX

Abstract

            Hydroxychloroquine overdose was a relatively uncommon event prior to the COVID-19 pandemic. However, due to the massive increase in prescriptions, coupled with the search for possibly effective treatment COVID-19 infection, these overdoses have become more frequent.  The management of severe hydroxychloroquine overdose does not have any well-established protocols. This report highlights the clinical course and successful management of a life-threatening hydroxychloroquine overdose. An 80-year-old man was admitted to the ICU in shock after a potentially lethal ingestion of hydroxychloroquine for COVID-19 prophylaxis in a COVID-19 negative patient. Treatments included sodium bicarbonate infusion, high dose diazepam, norepinephrine and epinephrine, and continuous electrolyte repletion. After 5 days in the intensive care unit, the patient recovered and was discharged home. In conclusion, hydroxychloroquine overdose can result in life-threatening rapid decompensation requiring gastric decontamination, alkalization, high dose diazepam, hemodynamic support, and frequent electrolyte replacement.

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Published
2022-07-22
How to Cite
Cohen, M., Miklovic, T., & Lott, N. (2022). When COVID-19 prophylaxis leads to hydroxychloroquine poisoning. The Southwest Respiratory and Critical Care Chronicles, 10(44), 52-56. https://doi.org/10.12746/swrccc.v10i44.1053