Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Serotonin Syndrome After an Overdose of Dextromethorphan and Chlorpeniramine: Two Case Reports

덱스트로메토판과 클로르페니라민 과용으로 인한 세로토닌 증후군 2례

  • Jung, Kwang Yul (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Yun, Sung Hyun (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Jung, Hyun Min (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Kim, Ji Hye (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Han, Seung Baik (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Kim, Jun Sig (Department of Emergency Medicine, College of Medicine, Inha University) ;
  • Paik, Jin Hui (Department of Emergency Medicine, College of Medicine, Inha University)
  • 정광율 (인하대학교 의과대학 응급의학교실) ;
  • 윤성현 (인하대학교 의과대학 응급의학교실) ;
  • 정현민 (인하대학교 의과대학 응급의학교실) ;
  • 김지혜 (인하대학교 의과대학 응급의학교실) ;
  • 한승백 (인하대학교 의과대학 응급의학교실) ;
  • 김준식 (인하대학교 의과대학 응급의학교실) ;
  • 백진휘 (인하대학교 의과대학 응급의학교실)
  • Received : 2013.05.23
  • Accepted : 2013.06.07
  • Published : 2013.06.13
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Abstract

Dextromethorphan and chlorpeniramine are common ingredients of over-the-counter (OTC) cough pills. They are known to be safe when used alone, however, combination with other serotonergic drugs or use of an overdose can cause serotonergic toxicity. We report on a 43-year-old male and a 57-year-old female who ingested an overdose of antitussive drugs containing dextromethorphan and chlorpeniramine. They commonly presented with altered mentality and hyperreflexia on both upper and lower extremities. After conservative therapies, they were discharged with alert mentality. These cases are meaningful in that there are few cases of serotonin syndrome with an overdose of a combination of dextromethorphan and chlorpeniramine. Careful use with medication counseling for OTC cough pills is needed in order to prevent overdose of these ingredients.

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