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Cardiac arrest with residual blindness after overdose of Tessalon® (benzonatate) perles.

AbstractBACKGROUND:
The extent to which benzonatate (Tessalon®), a structurally similar agent to other local anesthetics including tetracaine and procaine, poses a risk to the public is not fully appreciated as it is still one of the most widely prescribed antitussives available.
OBJECTIVES:
To report a case of cardiac arrest with residual blindness after Tessalon® overdose, review its clinical manifestations, toxicology and management considerations, and describe the need for rational prescribing.
CASE REPORT:
A 17-year-old woman with no previous medical history presented to the Emergency Department (ED) status post cardiac arrest. One to two hours prior, the patient had ingested at least 10 200-mg Tessalon® capsules as part of a suicide attempt. The patient was sedated, intubated, and given magnesium as prophylaxis against recurrent dysrhythmias. Emergent gastric lavage was performed and well tolerated. A 24-h hypothermia protocol with 6-h cooling period was initiated. Toxicological studies, chest radiograph, and a computed tomography scan of the head were all unremarkable. The patient was admitted to the Pediatric Intensive Care Unit for further work-up and supportive care. The patient was extubated and able to follow some commands 1 week post-admission. The patient developed blindness and experienced generalized confabulations, which did not resolve.
CONCLUSION:
Ingestion of Tessalon®, a seemingly innocuous and widely prescribed antitussive, may pose a risk to patients due to its potential for the rapid development of life-threatening adverse events and limited treatment options in the overdose setting. Rational prescribing and patient education is needed.
AuthorsVictor Cohen, Samantha P Jellinek, Lindsay Stansfield, Henry Truong, Cindy Baseluos, John P Marshall
JournalThe Journal of emergency medicine (J Emerg Med) Vol. 41 Issue 2 Pg. 166-71 (Aug 2011) ISSN: 0736-4679 [Print] United States
PMID19892505 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2011 Elsevier Inc. All rights reserved.
Chemical References
  • Antitussive Agents
  • Butylamines
  • benzonatate
Topics
  • Adolescent
  • Antitussive Agents (poisoning)
  • Blindness (chemically induced)
  • Butylamines (poisoning)
  • Drug Overdose
  • Female
  • Heart Arrest (chemically induced)
  • Humans
  • Suicide, Attempted
  • Treatment Outcome

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