Floctafenine

COlDa in cirrhosis A 53-year-old alcoholic with cirrhosis, chronic pancreatitis and duodenal ulcer was treated unsuccessfully with floctafenine (600mg/day) for relief of radiating epigastric pain. 24 hours after the dose was increased to I 200mg / day, the patient entered a deep coma (grade IV) and all oral drugs were stopped including his previous medications which consisted of spironolactone (200mg/day), frusemide (furosemide; 25mg every other day), and cimetidine (400mg at night). However, cimetidine(800mg/day) was continued IV along with lactulose enemas and the patient awoke over the next 24 hours. Spontaneous worsening of liver function as a cause of encephalopathy seems unlikely, as the alcoholic hepatitis was improving at the time of coma. 'The close temporal relation between/locta.fenine administration and coma indicates a causal linkage .. P""'Iua, P. eta], Annals of Inrernal Medicine 96: 253 (Feb 19821

0157-7271/82/0402-0005/0$01.00/0 © ADIS Press Reactions 2 Apr 1982 5