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Two days ago we admitted a 2 year old child who had ingested from 1 to 5
quinidine 300mg tablets. She had first been brought to an outlying hospital
where she was give a dose of charcoal, which she promply expectorated, and
labs were drawn. She was looked and put back into the ambulance and sent to
my hospital. She came in with a Quinidine level of 5.4. She was in the
midst PVC, Ventricular Tac, Atrial Tac, AV mismatch, (atrial rate=240, vent
rate=180) etc. We gave her a dose of Ascorbic acid 500mg IM then started her
on a drip of 1/6molar Sodium Lactate. Within 24 hours her level had fallen
to 2.0+/- 0.1. Today, her level was 0.9. There were no apparent CNS effects
and the cardiac rhythm was a nice even pace. Like nothing had ever happened.
Question... Has anyone else used Sodium Lactate for Quinidine OD and if so,
what rate did you infuse and for how long? Are there any references out
there for this use.
Incidently the child was 15kg. and 36inches long. Her ClCr was >100ml/min.
All labs were within normal ranges.
Robert Aucoin RPh.
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