عنوان

A Massive Overdose of Dalfampridine

شماره

LA67c451bv

زبان متن نوشتاري يا گفتاري و مانند آن

انگلیسی

عنوان اصلي

A Massive Overdose of Dalfampridine

نام عام مواد

[Article]

نام نخستين پديدآور

Fil, Laura J.; Sud, Payal; Sattler, Steve

متن يادداشت

Multiple sclerosis (MS) is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system. Dalfampridine (4-aminopyridine) was approved by the Food and Drug Administration in January 2010 for treatment of MS. Our patient was a 34-year-old male with a history of MS, who was brought to the emergency department after being found unresponsive. His current medications were valacyclovir, temazepam, dalfampridine (4-AP) and a tysabri intravenous (IV) infusion. Fifteen minutes after arrival the patient seized. The seizures were refractory to benzodiazepines, barbiturates and phenytoin. The 4-AP level was 530ng/mL (25ng/mL and 49ng/mL). The patient stopped seizing on hospital day 3 and was discharged 14 days later with normal mental status and neurologic exam. 4-AP is a potassium channel blocker that blocks the potassium ion current of repolarization following an action potential. The blockade of the potassium channel at the level of the membrane widens the action potential and enhances the release of acetylcholine, thus increasing post-synaptic action potentials. The treatment of patients with 4-AP overdose is supportive. Animal data suggest that patients with toxic levels of 4-AP may respond to phenytoin. Our case illustrates the highest recorded level of 4-AP in an overdose. Our patient appeared to be refractory to a combination of high doses of anticonvulsants and only improved with time.

تاريخ نشر

2015

عنوان

Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

شماره جلد

16/7

عنصر شناسه اي

Fil, Laura J.; Sud, Payal; Sattler, Steve

نام الکترونيکي

نوع ماده

[Article]

کد کاربرگه

275578

سطح دسترسي

a

تكميل شده

Y