Baclofen Toxicity in a Patient with Hemodialysis-Dependent End-Stage Renal Disease.

Publication/Presentation Date

10-24-2016

Abstract

BACKGROUND: Oral baclofen toxicity is extremely rare, but can affect patients with renal disease due to the drug's predominant renal clearance of approximately 69-85%. Patients with severely impaired renal function typically develop symptoms soon after initiating baclofen therapy, even at relatively low doses.

CASE REPORT: A 69-year-old woman with a history of hemodialysis-dependent end-stage renal disease presented to the Emergency Department with encephalopathy, ataxia, and dystonia after the addition of a recent baclofen prescription for back pain (10 mg twice daily). She had been taking baclofen as prescribed for approximately 1 week when, the day prior to admission, she had increased her dose to a total of 40 mg. Diagnostic studies demonstrated the patient had chronic, end-stage renal disease and a supratherapeutic concentration of baclofen. Signs and symptoms resolved with hemodialysis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is of critical importance for emergency physicians to appreciate impaired baclofen clearance in those with underlying renal disease to obviate the potential for significant drug toxicity.

Volume

52

Issue

4

First Page

e99

Last Page

e100

ISSN

0736-4679

Disciplines

Emergency Medicine

PubMedID

27789113

Department(s)

Department of Emergency Medicine, Department of Emergency Medicine Faculty, Department of Emergency Medicine Residents

Document Type

Article

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