title: Severe metabolic acidosis after acute naproxen sodium ingestion.
abstract: Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is a propionic acid derivative that possesses analgesic and antipyretic properties through inhibition of prostaglandin synthesis. The propionic acids have been considered the least toxic of the NSAIDs, and one, ibuprofen, is currently available as an over-the-counter medication. Though acidosis has been reported with ibuprofen, no such occurrence has been reported for naproxen sodium. We report the case of a 15-year-old girl who presented with severe metabolic acidosis and seizures that rapidly followed naproxen sodium ingestion. Serum bicarbonate levels returned to normal 12 hours after admission and correlated with the known pharmacokinetics of naproxen. The pharmacokinetics of naproxen and treatment of its overdose, and possible mechanisms of metabolic acidosis are reviewed.
authors.affiliation: Department of Emergency, Stanford University Hospital, California 94402.
authors.forename: R
authors.initials: R
authors.lastname: Martinez
authors.forename: D W
authors.initials: DW
authors.lastname: Smith
authors.forename: L R
authors.initials: LR
authors.lastname: Frankel
mesh_terms: D000138:Acidosis / Q000139:chemically induced*; D000293:Adolescent; D001639:Bicarbonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009288:Naproxen / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D012640:Seizures / Q000139:chemically induced*; D012964:Sodium / Q000627:therapeutic use; D017693:Sodium Bicarbonate
chemical_list: D001639:Bicarbonates; D009288:Naproxen; D017693:Sodium Bicarbonate; D012964:Sodium