Citation

Lelièvre B, Drouillard I, Thill C, Le Roux G, Bruneau C, Mahé J, Deguigne M, Boels D. Basic Clin. Pharmacol. Toxicol. 2019; ePub(ePub): ePub.

Affiliation

Poison Control Center, CHU, F-Angers.

Copyright

(Copyright © 2019, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.13365

PMID

31742906

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are well known for their most frequent side effects (digestive, renal and metabolic disorders) but are lesser known for other effects, such as coagulation disturbances. In this issue, we report the case of a 58-year-old woman who ingested 26g of naproxen in a suicidal attempt and developed cardiovascular shock, hypocoagulability and thrombopenia. Her outcome was positive (extubation three days after admission (D3), correction of hemostatic disruptions on D5 and of thrombopenia on D6). Naproxen plasma concentration was at a toxic concentration of 1,320 mg/L at six hours after drugs ingestion. Only few cases of hypocoagulopathy are reported with the NSAIDs and this is the first case that can be attributed to naproxen. A possible explanation of this phenomenon following naproxen ingestion is an inhibition of thromboxane A2, usually attributed to NSAIDs, combined with an inhibition of activation of downstream the cascade.

© 2019 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Language: en

Keywords

hypocoagulopathy; naproxen; thrombopenia; thromboxane A2