The X factor: Lack of bleeding after an acute apixaban overdose
We present an acute apixaban overdose without reported coingestants; it is the first such case report associated with multiple serum drug levels to assist in determining overdose kinetics. A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/...
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| Veröffentlicht in: | The American journal of emergency medicine 2017-05, Vol.35 (5), p.801.e5-801.e6 |
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| container_end_page | 801.e6 |
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| container_issue | 5 |
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| container_title | The American journal of emergency medicine |
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| creator | Leikin, Scott M. Patel, Hina Welker, Katherine L. Leikin, Jerrold B. |
| description | We present an acute apixaban overdose without reported coingestants; it is the first such case report associated with multiple serum drug levels to assist in determining overdose kinetics. A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/kg) of her spouse's apixaban medication. She denied coingestants, and did not take her prescribed medications that day. Her vital signs were normal and she denied symptoms. Chemistry and hematology labs were unremarkable. Plasma apixaban concentrations were 2765.6 ng/ml at 14 hours post ingestion with a non-linear half life. There was no utilization of blood products or factor replacement. There was never any bleeding, and her hemoglobin did not decrease. This case demonstrates that a single ingestion of apixaban can occur without any complications occurring. |
| doi_str_mv | 10.1016/j.ajem.2016.11.035 |
| format | Article |
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A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/kg) of her spouse's apixaban medication. She denied coingestants, and did not take her prescribed medications that day. Her vital signs were normal and she denied symptoms. Chemistry and hematology labs were unremarkable. Plasma apixaban concentrations were 2765.6 ng/ml at 14 hours post ingestion with a non-linear half life. There was no utilization of blood products or factor replacement. There was never any bleeding, and her hemoglobin did not decrease. 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All rights reserved.</rights><rights>Copyright Elsevier Limited 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-a42cad443364979476f0c49cafd0d3b849508e5b047d44e6dae7e6e180e30c6b3</citedby><cites>FETCH-LOGICAL-c384t-a42cad443364979476f0c49cafd0d3b849508e5b047d44e6dae7e6e180e30c6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1902499248?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27884586$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leikin, Scott M.</creatorcontrib><creatorcontrib>Patel, Hina</creatorcontrib><creatorcontrib>Welker, Katherine L.</creatorcontrib><creatorcontrib>Leikin, Jerrold B.</creatorcontrib><title>The X factor: Lack of bleeding after an acute apixaban overdose</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>We present an acute apixaban overdose without reported coingestants; it is the first such case report associated with multiple serum drug levels to assist in determining overdose kinetics. A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/kg) of her spouse's apixaban medication. She denied coingestants, and did not take her prescribed medications that day. Her vital signs were normal and she denied symptoms. Chemistry and hematology labs were unremarkable. Plasma apixaban concentrations were 2765.6 ng/ml at 14 hours post ingestion with a non-linear half life. There was no utilization of blood products or factor replacement. There was never any bleeding, and her hemoglobin did not decrease. This case demonstrates that a single ingestion of apixaban can occur without any complications occurring.</description><subject>Administration, Oral</subject><subject>Anticoagulants</subject><subject>Apixaban</subject><subject>Bleeding</subject><subject>Case reports</subject><subject>Charcoal</subject><subject>Drug dosages</subject><subject>Drug Overdose</subject><subject>Emergency medical care</subject><subject>Factor Xa Inhibitors - pharmacokinetics</subject><subject>Factor Xa Inhibitors - poisoning</subject><subject>Female</subject><subject>Half-Life</subject><subject>Hematology</subject><subject>Hemoglobin</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Ingestion</subject><subject>Medical laboratories</subject><subject>Middle Aged</subject><subject>Overdose</subject><subject>Plasma</subject><subject>Pyrazoles - pharmacokinetics</subject><subject>Pyrazoles - poisoning</subject><subject>Pyridones - pharmacokinetics</subject><subject>Pyridones - poisoning</subject><subject>Tablets</subject><subject>Treatment Outcome</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kMtKxDAUhoMoOl5ewIUE3Lhpza1JKoKIeIMBNwruQpqeautMMybtoG9vhlEXLlydc-D7fw4fQoeU5JRQedrltoN5ztKeU5oTXmygCS04yzRVdBNNiOJFJlWhdtBujB0hlIpCbKMdprQWhZYTdPH4CvgZN9YNPpzhqXVv2De4mgHUbf-CbTNAwLbH1o0DYLtoP2yVTr-EUPsI-2irsbMIB99zDz3dXD9e3WXTh9v7q8tp5rgWQ2YFc7YWgnMpSlUKJRviROlsU5OaV1qUBdFQVESoRIGsLSiQQDUBTpys-B46Wfcugn8fIQ5m3kYHs5ntwY_RUC0EYUIyltDjP2jnx9Cn7wwtE1OWTOhEsTXlgo8xQGMWoZ3b8GkoMSu9pjMrvWal11Bqkt4UOvquHqs51L-RH58JOF8DkFwsWwgmuhZ6l2QGcIOpfftf_xdEzIjo</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Leikin, Scott M.</creator><creator>Patel, Hina</creator><creator>Welker, Katherine L.</creator><creator>Leikin, Jerrold B.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201705</creationdate><title>The X factor: Lack of bleeding after an acute apixaban overdose</title><author>Leikin, Scott M. ; 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A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/kg) of her spouse's apixaban medication. She denied coingestants, and did not take her prescribed medications that day. Her vital signs were normal and she denied symptoms. Chemistry and hematology labs were unremarkable. Plasma apixaban concentrations were 2765.6 ng/ml at 14 hours post ingestion with a non-linear half life. There was no utilization of blood products or factor replacement. There was never any bleeding, and her hemoglobin did not decrease. This case demonstrates that a single ingestion of apixaban can occur without any complications occurring.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27884586</pmid><doi>10.1016/j.ajem.2016.11.035</doi></addata></record> |
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| subjects | Administration, Oral Anticoagulants Apixaban Bleeding Case reports Charcoal Drug dosages Drug Overdose Emergency medical care Factor Xa Inhibitors - pharmacokinetics Factor Xa Inhibitors - poisoning Female Half-Life Hematology Hemoglobin Hemorrhage Humans Ingestion Medical laboratories Middle Aged Overdose Plasma Pyrazoles - pharmacokinetics Pyrazoles - poisoning Pyridones - pharmacokinetics Pyridones - poisoning Tablets Treatment Outcome |
| title | The X factor: Lack of bleeding after an acute apixaban overdose |
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