Richardson William, Fisher Dan, Hassinger Stanley, Culy Daniel, Zmuda Anna
Emergency Medicine, Prisma Health Midlands, Columbia, USA.
Palmetto Poison Center, University of South Carolina College of Pharmacy, Columbia, USA.
Cureus. 2025 Jul 22;17(7):e88512. doi: 10.7759/cureus.88512. eCollection 2025 Jul.
We present a case of an overdose of hydroxychloroquine with severe toxicity and describe the hospital management of the patient. The management of large ingestions can provide significant challenges for the emergency medicine physician, as these patients can present in extremis. A 49-year-old woman presented to the emergency department (ED) two hours following a reported ingestion of 24 grams of hydroxychloroquine in a suicide attempt. The patient developed hypotension, ventricular arrhythmias including torsades de pointes, and profound hypokalemia. She was managed with intravenous fluid resuscitation, mechanical ventilation, vasopressors, electrolyte replacement, high-dose intravenous diazepam, sodium bicarbonate, and lidocaine infusions. The patient was ultimately able to be discharged home neurologically intact. Reported hydroxychloroquine overdoses are relatively infrequent. Understanding the toxicity and management of hydroxychloroquine overdoses is particularly important now, as the prescription rate of hydroxychloroquine increased during the COVID-19 pandemic and has remained high despite the failure of studies to demonstrate a reduction in morbidity and mortality when used for the treatment of COVID-19.
我们报告一例羟氯喹严重中毒过量的病例，并描述患者在医院的治疗情况。大量摄入药物的处理对急诊医生来说是巨大挑战，因为这些患者可能处于危急状态。一名49岁女性在试图自杀服用24克羟氯喹两小时后被送往急诊科。患者出现低血压、包括尖端扭转型室速在内的室性心律失常以及严重低钾血症。对其进行了静脉补液复苏、机械通气、血管加压药、电解质补充、大剂量静脉注射地西泮、碳酸氢钠和利多卡因输注等治疗。患者最终神经功能完好地出院回家。报道的羟氯喹过量中毒相对较少见。鉴于在新冠疫情期间羟氯喹的处方率上升，且尽管研究未能证明其用于治疗新冠时能降低发病率和死亡率，但该处方率仍居高不下，了解羟氯喹过量中毒的毒性及处理尤为重要。
