Mini Episode: Managing Crashing Hydroxychloroquine/Chloroquine OD

Quick Review: Chloroquine and Hydroxychloroquine ToxicityToxic DoseChloroquine: >5 g is associated with severe toxicity (though toxicity can occur at lower doses).Hydroxychloroquine (HCQ): Toxic dose is less well-defined.Clinical EffectsSeizures: Due to sodium channel blockade.Arrhythmias: Resulting from sodium channel blockade.Hypotension: Caused by alpha-adrenergic blockade.Hypokalemia: Often a notable feature.ManagementDecontamination:Administer activated charcoal if the patient is awake, alert, and has no risk of emesis.Supportive Care:High-dose epinephrine:Recommended dose: 0.25 mcg/kg/min.Based on retrospective case-control series: https://www.nejm.org/doi/full/10.1056/NEJM198801073180101Diazepam:Administer 1–2 mg/kg over 30 minutes, followed by 1–2 mg/kg over 24 hours.Prevents seizures and may provide cardioprotective effects.Airway Management:Consider early intubation to secure the airway in deteriorating cases.Expert Consultation:Contact a poison center for guidance: 1-800-222-1222.A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: [email protected] Show ResourcesRyan's Medical Games and ResourcesShow Website