Title
Three cases of substitution errors leading to hyoscine hydrobromide overdose Three cases of substitution errors leading to hyoscine hydrobromide overdose
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Philadelphia, Pa ,
Subject
Human medicine
Source (journal)
Clinical toxicology. - Philadelphia, Pa
Volume/pages
43(2005) :7 , p. 861-865
ISSN
1556-3650
ISI
000233940400006
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Abstract
We report three patients with anticholinergic poisoning caused by the substitution of hyoscine hydrobromide for hyoscine butylbromide in preparations compounded by two different pharmacists. The patients took the preparations for gastrointestinal discomfort and presented with altered mental status, tachycardia, facial flushing, dilated pupils, and dry skin shortly after the ingestion. In one patient the intoxication was initially not recognized and he was treated as suffering from an acute cerebrovascular accident. Two patients experienced long-lasting effects such as decreased ability to concentrate, memory disturbances, tremor, and photo- and phonophobia. It was obviously impossible to elucidate the exact nature of the relationship between the intoxication and these long-lasting complaints. Information from the Belgian poison control center revealed that cases of substitution error with hyoscine hydrobromide are not unique. The Belgian authorities issued a warning to all pharmacists.
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