Open AccessPheniramine maleate-induced rhabdomyolysis and aki: Is it fatal?
Author(s) -
K Venugopal,
Mallikarjun M Reddy,
MY Bharathraj,
Kadappa Jaligidad,
D P Kushal
Publication year - 2014
Publication title -
toxicology international/indian journal of toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.129
H-Index - 26
eISSN - 0976-5131
pISSN - 0971-6580
DOI - 10.4103/0971-6580.155384
Subject(s) - rhabdomyolysis , medicine , hemodialysis , antidote , tachycardia , anesthesia , acute kidney injury , toxicity
Pheniramine maleate is an easily accessible, over-the-counterantihistaminic, which is frequently involved in overdoses. Pheniramine has antimuscarinic effect causing tachycardia, dilated pupils, urinary retention, and dry flushed skin, and decreased bowel sounds, confusion, mild increase in body temperature, cardiac arrhythmias, and seizures at lethal doses. It has not been implicated as an important cause of rhabdomyolysis and acute kidney injury (AKI). Rhabdomyolysis causing AKI is rarely reported in the literature. This case report emphasizes the occurrence of nontraumatic rhabdomyolysis in pheniramine maleate overdose which required hemodialysis. Since there is a lack of a specific antidote, treatment is mainly symptomatic and supportive. We report a fatal case of a young male with a very high dose of consumption of pheniramine maleate (4.077 g), which was complicated by seizures, respiratory depression, nontraumatic rhabdomyolysis, and AKI. Despite hemodialysis, ventilator support, and other intensive supportive care, patient could not survive and death ensued due to multiorgan dysfunction syndrome.