Management of amikacin overdose.
A woman with subarachnoid hemorrhage inadvertently received 18 g of amikacin over a 4-hr period, 20 times the recommended total daily dose. Intravenous fluids were administered to expedite renal excretion of the amikacin, and a peritoneal dialysis was performed to augment drug elimination. Drug levels were measured sequentially in serum, urine, and peritoneal dialysate. Renal clearance of the drug was increased compared to clearance following a standard dose and the drug was rapidly excreted in the urine. Amikacin was not detected in the peritoneal dialysate. There were no apparent toxic effects from the overdose. A patient with normal renal function who receives a potentially toxic dose of amikacin can be appropriately managed by careful hydration and maintenance of a generous diuresis.
D000328:Adult; D000583:Amikacin / Q000097:blood / Q000506:poisoning* / Q000652:urine; D004231:Diuresis / Q000187:drug effects; D005260:Female; D006801:Humans; D007612:Kanamycin / Q000031:analogs & derivatives*; D010530:Peritoneal Dialysis; D012965:Sodium Chloride / Q000627:therapeutic use
D012965:Sodium Chloride; D007612:Kanamycin; D000583:Amikacin