Intoxication with over-the-counter antitussive medication containing dihydrocodeine and chlorpheniramine causes generalized convulsion and mixed acidosis.
We report a 35-year-old man who was referred to our hospital with generalized convulsion and mixed acidosis presumably caused by abuse of SS-BRON tablets, an over-the-counter (OTC) antitussive medication sold in Japan. These tablets contain dihydrocodeine phosphate, methylephedrine, chlorpheniramine, and caffeine. Although it is difficult to discern which component caused these symptoms, it seems that dihydrocodeine phosphate or methylephedrine was involved in the addiction to SS-BRON and chlorpheniramine may have caused the generalized convulsion. It should be recognized that an OTC antitussive, which is quite easy to obtain, can be abused and subsequently induce serious intoxication.
Murao
Satoshi
S
Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama. smurao@matsuyama-shimin-hsp.or.jp
Manabe
Hiroaki
H
Yamashita
Tetsuji
T
Sekikawa
Takashi
T
D000138:Acidosis / Q000139:chemically induced*; D000328:Adult; D000996:Antitussive Agents / Q000633:toxicity*; D002744:Chlorpheniramine / Q000633:toxicity*; D003061:Codeine / Q000031:analogs & derivatives* / Q000633:toxicity; D004809:Ephedrine / Q000031:analogs & derivatives / Q000633:toxicity; D006801:Humans; D007564:Japan; D008297:Male; D004366:Nonprescription Drugs / Q000633:toxicity; D012640:Seizures / Q000139:chemically induced*; D019966:Substance-Related Disorders / Q000150:complications
D000996:Antitussive Agents; D004366:Nonprescription Drugs; D002744:Chlorpheniramine; C041707:N-methylephedrine; D004809:Ephedrine; C014481:dihydrocodeine; D003061:Codeine