Zomepirac overdose*

Lethargy and drowsiness: first report A 34-year-old male was admitted in a state ofIethargy and drowsiness. 3-4 hours after ingestion of 30- 40 tablets of zomepirac ( I OOmg) which be bad taken for relief of a headache which bad persisted for several days. The patient had no apparent suicidal thoughl~ or any psychiatric illness but had a history of severe recurri fig headaches over the past 5 months. These were related to a brain cyst. B P. pulse and respiration were normal. He was subsequently transferred to a medical centre for neurological and psychiatric examination. Vital signs were still normal and vomiting was induced with a repeat da;e of 30ml ipecac syrup. Milk of magnesia (30mB and naloxone (O.4mg) were given in addition. Laboratory values were normal except for an elevated serum creatinine ( I.7mg/ IOOml). The patient's subsequent recovery was uneventful. Overdosage wi th NS AI Ds are rare but have been reported with ibuprofen, naproxen, fenoprofen and indomethacin. Clinical symptoms are consistent consisting of drowsiness, lethargy, disorientation, nausea and at times gastrointestinal distress. These generally resolve in the first 24 hours. Hypotension, apnoea and acidosis occur rarely. As there is no known antidote, treatment is supportive and consists of induction of vomiting by ipecac, gastric lavage, administration of activated charcoal, and alkalinisation with sodium bicarbonate in cases of acidosis. The patient should also be closely monitored for renal function gastrointestinal bleeding and cardiovascular sequelae.

Joubert, 0 w.: Drug I ntell isence and Clinical Pharmacy [6: 328 ("'pr [9E2)

0157-7271!B2!0611-0007!O$01.(JO!O © ADIS Pres~ Reactions 11 Jun 1982 7