Dologesic is a commonly prescribed analgesic in accident and emergency department. Yet report of overdose with this drug is not common. We report a case in which the patient developed cardiac arrest within an hour of ingestion. Dextropropoxyphene, a component of the drug Dologesic, used to be a common cause of fatalities after drug overdose in the seventies. It is highly toxic in overdose and therefore caution should be exercised when prescribing this drug.
WhittingtonR.M., BarclayA.D.The epidemiology of dextropropoxyphene (Distalgesic) overdose fatalities in Birmingham and the West Midlands. J Clin Hosp Pharm1981; 6(4): 251–7.
6.
SimonsenJ.Accidental fatal drug poisoning with particular reference to dextropropoxyphene. Forensic Sci1977; 10(2): 127–32.
7.
RejentT.A., MichalekR.W., LehotayJ.M.Propoxyphene-associated deaths: methods, post-mortem levels in blood and liver. Clin Toxicol1977; 11(1): 43–51.
8.
JonassonU., JonassonB., SaldeenT.The manner of death among fatalities where dextropropoxyphene caused or contributed to death. Forensic Sci Int1998; 96(2-3): 181–7.
9.
JonassonU., JonassonB., SaldeenT.Correlation between prescription of various dextropropoxyphene preparations and their involvement in fatal poisonings. Forensic Sci Int1999; 103(2): 125–32.
10.
CarsonD.J.Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases. Lancet1977; 1(8017): 894–7.
11.
SegestE., HarrisC.N., BayH.Dextropropoxyphene deaths in Denmark from the health authority point of view. Med Law1993; 12(1-2): 141–51.
12.
JonassonU., JonassonB., SaldeenT.Suicides may be overreported and accidents underreported among fatalities due to dextroporpoxyphene. J Forensic Sci1999; 44(2): 334–8.
13.
JonassonU., JonassonB., HolmgrenR.The prevalence of dextroporpoxyphene in autopsy blood samles. Forensic Sci Int1998; 96(2-3): 135–42.
14.
YoungR.J.Dextropropoxyphene overdosage. Pharmacological considerations and clinical management. Drugs1983; 26(1): 70–9.
15.
SegestE.Poisoning with dextropropoxyphene in Denmark. Hum Toxicol1987; 6(3): 203–7.
16.
WeissI.S.Optic atrophy after propoxyphene overdose: report of a case. Ann Ophthalmol1982; 14(6): 586–7.
17.
ElonenE., NeuvonenP.J.Mixed dextropropoxyphene poisoning: concentration-effect relationships and effect of naloxone. Int J Clin Pharmacol Ther Toxicol1984; 22(1): 16–9.
18.
YoungR.J., LawsonA.A.Distalgesic poisoning- cause for concern. Br Med J1980; 289(6220): 1045–7.
KrantzT., ThistedB., StromJ.Sorensen MB. Severe acute propoxyphene overdose: plasma concentrations of propoxyphene and norpropoxyphene and the effect of dopamine on circulatory failure. Acta Anaesthesiol Scand1986; 30(4): 271–6.
HantsonP., EvenepoelM., ZiadeD.Adverse cardiac manifestations following dextroporpoxyphene overdose: can naloxone be helpful?Ann Emerg Med1995; 25(2): 263–6.
23.
SchouJ., AngeloH., DamW.Pharmacokinetics of dextropropoxyphene in acute poisoning. Arch Toxicol Suppl1978; (1): 343–6.
24.
HeaneyR.M.Left bundle branch block associated with propoxyphene hydrochloride poisoning. Ann Emerg Med1983; 12(12): 780–2.
25.
HenryJ.A., CassidyS.L.Membrane stabilising activity: a major cause of fatal poisoning. Lancet1986; 1(8495): 1414–7.
26.
WhitcombD.C., GilliamF.R., StarmerC.F.Marked QRS complex abnormalities and sodium channel blockade by propoxyphene reversed with lidocaine. J Clin Invest1989; 84(5): 1629–36.
27.
StorkC.M., ReddJ.T., FineK.Propoxyphene-induced wide QRS complex dysrhythmia responsive to sodium bicarbonate- a case report. J Toxicol Clin Toxicol1995; 33(2): 179–83.
28.
LawsonA.A., NorthridgeD.B.Dextropropoxyphene overdose. Epidemiology, clinical presentation and management. Med Toxicol Adverse Drug Exp1987; 2(6): 430–44.
29.
ThamdrupB., OstergaardO.V., ClausenE.Plasma exchange in the treatment of propoxyphene intoxications. Int J Clin Pharmacol Ther Toxicol1986; 24(7): 379–80.
30.
MooreR.A., RumackB.H., ConnerC.S.Naloxone: underdosage after narcotic poisoning. Am J Dis Child1980; 134(2): 156–8.