Reactions 1704, p30 - 2 Jun 2018 O S Various toxicities: case report A 48-year-old woman developed unresponsive, anti- cholinergic symptoms and macroscopic haematuria following an overdose of apixaban. Additionally, she also developed decreasing gastrointestinal motility, that resulted in requirement of longer time to normalise her coagulation tests secondary to amitriptyline poisoning, possibly due to overdose [not all durations of treatment to reaction onsets not stated]. The woman, who had hypertension, hypothyroidism and depression, ingested apixaban 210mg and amitriptyline unknown amount, at most 2.5g [exact dosage not stated] along with levothyroxine-sodium [levothyroxine]. Approximately 13h later, she was found unresponsive on her kitchen floor. Two months before, she was prescribed apixaban for bilateral pulmonary embolism. She was admitted to a high dependency unit following her unresponsiveness. She developed anti- cholinergic symptoms and mild transient macroscopic haematuria. Later, she was discharged from the hospital without any major bleeding. However, her coagulation tests took longer time to normalise due to associated amitriptyline poisoning, possibly due to overdose which decreased her gastrointestinal motility [not all outcomes stated]. Author comment: "We present a case that together with Leikin et al.’s report sheds light on the pharmacokinetics of massive apixaban overdose." "Our patient’s coagulation tests took longer time to normalize . . . possibly due to concurrent amitriptyline poisoning decreasing gastrointestinal motility." Ilicki J, et al. Massive apixaban overdose - A comparison of three cases. American Journal of Emergency Medicine 36: 891-893, No. 5, May 2018. Available from: URL: http://doi.org/10.1016/j.ajem.2017.09.035 - Sweden 803323283 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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