title: Chlorpropamide toxicity with survival despite 27-day hypoglycemia.
abstract: In the past 5 years at our institution, 12 cases involving the ingestion of chlorpropamide 3-15 g were fatal. We report a 23-year-old woman with an estimated ingestion of chlorpropamide 5-10 g. Initial cardiovascular collapse, attributed to the blockade of potassium channel transport, responded to intensive support including 3 days of cardiac pacing. Urinary excretion of chlorpropamide and hypoglycemia persisted until day 27. The toxic mechanisms and high risk of chlorpropamide are summarized. A fatal therapeutic dose ratio as low as 4:1 has made this antidiabetic agent obsolete.
authors.affiliation: Pomeranian Medical University, Szczecin, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Ciechanowski
authors.forename: K S
authors.initials: KS
authors.lastname: Borowiak
authors.forename: B A
authors.initials: BA
authors.lastname: Potocka
authors.forename: M
authors.initials: M
authors.lastname: Nowacka
authors.forename: G
authors.initials: G
authors.lastname: Dutkiewicz
mesh_terms: D000328:Adult; D002747:Chlorpropamide / Q000506:poisoning* / Q000652:urine; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000506:poisoning* / Q000652:urine; D012121:Respiration, Artificial; D012769:Shock / Q000139:chemically induced / Q000503:physiopathology; D013406:Suicide, Attempted
chemical_list: D007004:Hypoglycemic Agents; D002747:Chlorpropamide