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Polypharmacy overdose

Case contributed by Sahba Sabeti
Diagnosis almost certain

Presentation

Intentional overdose of numerous slow-release potassium and benzodiazepine tablets. Severe hyperkalemia on arrival to ED.

Patient Data

Age: 20-30 years
Gender: Female
x-ray

Innumerable gastric rounded opacities in keeping with tablet ingestion. There are at least 8 tablets distal to the pylorus.

Case Discussion

This is a case of massive polypharmacy overdose, primarily potassium supplements. The x-ray highlights the timing of recent ingestion (approximately 1 hour prior). The patient required endoscopic gastric decontamination, ICU support with dual concurrent haemodialysis, and survived.

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