Abstract
Survlval following attempted suicide in a 50-year-old man by ingestion of 12.4 g of mexlletine, 620 mg of nitedipine and 50 to 100 tabiets of sublingual nitroglycerine 1:150 is reported. Initial presentation was that of mental obtundation, vomiting, tonic-clonic seizure, high-degree atrioventricular block, profound vasodllation and cardiovascular collapse. Treatment consisted of intravenous calcium gluconate and aggresslve fluld management. Maintenance of cardiovascular stabillty required continuous infusion phenylephrine, dopamine and epinephrine. The patient made a full recovary and was medically discharged on the fourth hospital day. This case represents the largest overdose of mexiletine to date to end in patient surviyal.
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