Laxative-induced rhabdomyolysis
Alfonso Merante1, Pietro Gareri2,3, Norma Maria Marigliano2, Salvatore De Fazio2, Elvira Bonacci1, Carlo Torchia1, Gaetano Russo1, Pasquale Lacroce1, Roberto Lacava3, Alberto Castagna3, Giovambattista De Sarro2, Giovanni Ruotolo11Geriatrist, Geriatric Unit “Pugliese-Ciaccio” Hosp...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2010-03-01
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| Series: | Clinical Interventions in Aging |
| Subjects: | |
| Online Access: | https://www.dovepress.com/laxative-induced-rhabdomyolysis-peer-reviewed-article-CIA |
| _version_ | 1818342915563323392 |
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| author | Alfonso Merante Pietro Gareri Norma Maria Marigliano et al |
| author_facet | Alfonso Merante Pietro Gareri Norma Maria Marigliano et al |
| author_sort | Alfonso Merante |
| collection | DOAJ |
| description | Alfonso Merante1, Pietro Gareri2,3, Norma Maria Marigliano2, Salvatore De Fazio2, Elvira Bonacci1, Carlo Torchia1, Gaetano Russo1, Pasquale Lacroce1, Roberto Lacava3, Alberto Castagna3, Giovambattista De Sarro2, Giovanni Ruotolo11Geriatrist, Geriatric Unit “Pugliese-Ciaccio” Hospital, Catanzaro, Italy; 2Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, University Magna Graecia of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro, Italy; 3Geriatrist, Operative Unit Elderly Health Care, Catanzaro, ItalyAbstract: The present study describes a case of laxative-induced rhabdomyolysis in an elderly patient. An 87-year-old woman was hospitalized for the onset of confusion, tremors, an inability to walk, and a fever that she had been experiencing for 36 hours. She often took high dosages of lactulose and sorbitol syrup as a laxative (about 70 g/day). During her physical examination, the patient was confused, drowsy, and she presented hyposthenia in her upper and lower limbs, symmetric and diffuse moderate hyporeflexia, and her temperature was 37.8°C. Laboratory tests revealed severe hyponatremia with hypokalemia, hypocalcemia, hypochloremia, and metabolic alkalosis. Moreover, rhabdomyolysis markers were found. The correction of hydroelectrolytic imbalances with saline, potassium and sodium chlorure, calcium gluconate was the first treatment. During her hospitalization the patient presented acute delirium, treated with haloperidol and prometazine chloridrate intramuscularly. She was discharged 12 days later, after resolution of symptoms, and normalized laboratory tests. Over-the-counter drugs such as laxatives are usually not considered dangerous; on the other hand, they may cause serum electrolytic imbalance and rhabdomyolysis. A careful monitoring of all the drugs taken by the elderly is one of the most important duties of a physician since drug interactions and their secondary effects may be fatal.Keywords: rhabdomyolysis, laxatives, elderly, over-the-counter drugs |
| first_indexed | 2024-12-13T16:22:16Z |
| format | Article |
| id | doaj.art-6261b9897e00445698a93d08bf569e44 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-13T16:22:16Z |
| publishDate | 2010-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-6261b9897e00445698a93d08bf569e442022-12-21T23:38:42ZengDove Medical PressClinical Interventions in Aging1178-19982010-03-01Volume 571734128Laxative-induced rhabdomyolysisAlfonso MerantePietro GareriNorma Maria Mariglianoet alAlfonso Merante1, Pietro Gareri2,3, Norma Maria Marigliano2, Salvatore De Fazio2, Elvira Bonacci1, Carlo Torchia1, Gaetano Russo1, Pasquale Lacroce1, Roberto Lacava3, Alberto Castagna3, Giovambattista De Sarro2, Giovanni Ruotolo11Geriatrist, Geriatric Unit “Pugliese-Ciaccio” Hospital, Catanzaro, Italy; 2Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, University Magna Graecia of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro, Italy; 3Geriatrist, Operative Unit Elderly Health Care, Catanzaro, ItalyAbstract: The present study describes a case of laxative-induced rhabdomyolysis in an elderly patient. An 87-year-old woman was hospitalized for the onset of confusion, tremors, an inability to walk, and a fever that she had been experiencing for 36 hours. She often took high dosages of lactulose and sorbitol syrup as a laxative (about 70 g/day). During her physical examination, the patient was confused, drowsy, and she presented hyposthenia in her upper and lower limbs, symmetric and diffuse moderate hyporeflexia, and her temperature was 37.8°C. Laboratory tests revealed severe hyponatremia with hypokalemia, hypocalcemia, hypochloremia, and metabolic alkalosis. Moreover, rhabdomyolysis markers were found. The correction of hydroelectrolytic imbalances with saline, potassium and sodium chlorure, calcium gluconate was the first treatment. During her hospitalization the patient presented acute delirium, treated with haloperidol and prometazine chloridrate intramuscularly. She was discharged 12 days later, after resolution of symptoms, and normalized laboratory tests. Over-the-counter drugs such as laxatives are usually not considered dangerous; on the other hand, they may cause serum electrolytic imbalance and rhabdomyolysis. A careful monitoring of all the drugs taken by the elderly is one of the most important duties of a physician since drug interactions and their secondary effects may be fatal.Keywords: rhabdomyolysis, laxatives, elderly, over-the-counter drugshttps://www.dovepress.com/laxative-induced-rhabdomyolysis-peer-reviewed-article-CIArhabdomyolysislaxativeselderlyover-the-counter drugs |
| spellingShingle | Alfonso Merante Pietro Gareri Norma Maria Marigliano et al Laxative-induced rhabdomyolysis Clinical Interventions in Aging rhabdomyolysis laxatives elderly over-the-counter drugs |
| title | Laxative-induced rhabdomyolysis |
| title_full | Laxative-induced rhabdomyolysis |
| title_fullStr | Laxative-induced rhabdomyolysis |
| title_full_unstemmed | Laxative-induced rhabdomyolysis |
| title_short | Laxative-induced rhabdomyolysis |
| title_sort | laxative induced rhabdomyolysis |
| topic | rhabdomyolysis laxatives elderly over-the-counter drugs |
| url | https://www.dovepress.com/laxative-induced-rhabdomyolysis-peer-reviewed-article-CIA |
| work_keys_str_mv | AT alfonsomerante laxativeinducedrhabdomyolysis AT pietrogareri laxativeinducedrhabdomyolysis AT normamariamarigliano laxativeinducedrhabdomyolysis AT etal laxativeinducedrhabdomyolysis |