[Case of catecholamine-resistant shock caused by drug overdose].
A 27-year-old man with schizophrenia took an overdose of a psychotic agent. He became unconscious and had severe hypotension. Although he was diagnosed as having distributive shock caused by drug overdose and treated by hydration and catecholamine, the shock status was lasting. The use of vasopressin changed the situation dramatically. After the injection of vasopressin at maximum dose, 0.1 U/min, the dose of vasopressin could be tapered. He recovered from shock and was discharged on the third day without sequelae. There are an increasing number of reports that indicate that vasopressin is effective for distributive shock, especially catecholamine-resistant septic shock. It seems that the appropriate dose of vasopressin is under 0.04U/min considering the deterioration of cardiac function although the maximum dose of vasopressin was O.1U/min in this case. For that reason, monitoring by pulmonary artery catheter is recommended. The side effects of vasopressin should be discussed for appropriate use.
Sato
Rui
R
Tertiary Emergency Medical Center, Saitama Red Cross Hospital.
Shimizu
Keiki
K
Taguchi
Shigemasa
S
Sekii
Hajime
H
Yokote
Ryo
R
Kiyota
Kazuya
K
D000328:Adult; D050034:Antidiuretic Agents / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000506:poisoning*; D002395:Catecholamines / Q000627:therapeutic use; D062787:Drug Overdose; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D012559:Schizophrenia; D012769:Shock / Q000139:chemically induced* / Q000188:drug therapy*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D014667:Vasopressins / Q000008:administration & dosage*
D050034:Antidiuretic Agents; D014150:Antipsychotic Agents; D002395:Catecholamines; D014662:Vasoconstrictor Agents; D014667:Vasopressins