Colchicine Medinova Overdosage

Signs and Symptoms: Symptoms, the onset of which may be delayed, include nausea, vomiting, diarrhea, abdominal pain, hemorrhagic gastroenteritis, and burning pain in the throat, stomach, and skin. Fluid extravasation may lead to shock. Myocardial injury may be accompanied by ST-segment elevation, decreased contractility, and profound shock. Muscle weakness or paralysis may occur and progress to respiratory failure. Hepatocellular damage, renal failure, and lung parenchymal infiltrates may occur and, by the fifth day after the overdose, leukopenia, thrombocytopenia, and coagulopathy may also occur. If the patient survives, alopecia and stomatitis may be experienced. There is no clear separation of non toxic, toxic, and lethal doses of colchicine. The lethal dose of colchicine has been estimated to be 65 mg; however, death has resulted from acute doses as small as 7 mg. Serum concentrations that may be toxic or lethal are not defined. The intravenous median lethal dose in rats is 1.7 mg/kg.
Treatment: To obtain up-to-date information about the treatment of overdose, a good resource is the certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians' Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in the patient.
Protect the patient's airway and support ventilation and perfusion. Meticulously monitor and maintain, within acceptable limits, the patient's vital signs, blood gases, serum electrolytes, etc. Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal which, in many cases, is more effective than emesis or lavage; consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing gastric emptying or charcoal.
Forced diuresis, peritoneal dialysis, hemodialysis, or charcoal perfusion have not been established as beneficial for an overdose of colchicine.