• Internal medicine · Jun 2024

    Case Reports

    Polypharmacy-Related Shock Symptoms and Complications Associated with Phenothiazine: A Case Report.

    • Shunsuke Nakamura, Shingo Masuda, Shinya Oda, Daisuke Yamakawa, Shota Yamaguchi, Tamaki Ishima, Natsuka Kimura, and Kenichi Aizawa.
    • Department of General Internal Medicine, Kamigoto Hospital, Japan.
    • Intern. Med. 2024 Jun 15; 63 (12): 182918351829-1835.

    AbstractThis report describes a case of shock symptoms in a 72-year-old woman with epilepsy who had been in a state of polypharmacy, taking multiple antipsychotic drugs. After receiving a normal dose of periciazine, she exhibited impaired consciousness, hypothermia, and hypotension and was admitted to hospital. Despite poor response to vasopressors, conservative treatment led to gradual improvement. Subsequent pharmacokinetic analysis showed non-toxic blood concentrations of periciazine, suggesting that even small doses of phenothiazines could result in toxic symptoms. This case highlights the importance of monitoring for adverse reactions when prescribing multiple antipsychotic drugs, particularly in older polypharmacy patients.

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