Severe acute propoxyphene overdose: plasma concentrations of propoxyphene and norpropoxyphene and the effect of dopamine on circulatory failure

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Abstract
Twelve patients with cadiovascular failure because of propoxyphene self-poisoning were treated with dopamine. The patients responded favourably to dopamine infusion (2-17 .mu.g/kg/min) with a dose-dependent rise in systolic arterial blood pressure and a fall in central venous pressure and copious urinary output. Side effects during infusion were few, and in periods where dopamine infusion exceeded 10 .mu.g/kg/min no tachyarrhythmias were seen. Eleven of the patients were treated on a respirator. Two patients were discharged from the ICU with signs of hypoxic brain damage, one of whom recovered completely after 2 weeks. Serum propoxyphene and norpropoxyphene were measured in nine patients. All but one patient had either propoxyphene or norpropoxyphene concentrations above 3 .mu.mol/l.