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KMID : 1013220090070020156
Jouranl of the Korean Society of Clinical Toxicology
2009 Volume.7 No. 2 p.156 ~ p.163
The Predictive Factors of the Serum Creatine Kinase Level Normalization Time in Patients with Rhabdomyolysis due to Doxylamine Ingestion
Shin Min-Chul

Kwon Oh-Young
Lee Jong-Seok
Choi Han-Sung
Hong Hoon-Pyo
Ko Young-Gwan
Abstract
Purpose: Doxylamine succinate (DS) is frequently used to treat insomnia and it may induce rhabdomyolysis in the overdose cases. The purpose of this study is to evaluate the factors that can predict the serum creatine kinase (CK) level normalization time for patients with rhabdomyolysis due to DS ingestion.

Methods: This study was conducted on 71 patients who were admitted with rhabdomyolysis after DS ingestion during the period from January 2000 to July 2009. Rhabdomyolysis was defined as a serum CK level over 1,000 U/L. The collected data included the general characteristics, the anticholinergic symptoms, the ingested dose, the peak serum CK level, the time interval (TI) from the event to the peak CK level and the TI from the event to a CK level below 1,000 U/L. We evaluated the correlation between the patients¡¯ variables and the TI from the event to the peak CK level time and the time for a CK level below 1,000 U/L.

Results: The mean ingested dose per body weight (BW) was and the mean TI from the event to treatment was hours. The TI from the event to the peak CK level was longer for the patients with a larger ingestion dose per BW (r=0.587, p<0.05). The CK normalization time was longer for the patients with a larger ingested dose per BW (r=0.446, p<0.05) and a higher peak CK level (r=0.634, p<0.05).

Conclusion: The ingested dose per BW was correlated with the TI from the event to the peak CK level, and the ingested dose per BW and the peak CK level have significant correlations with the CK normalization time. These factors may be used to determine the discharge period of patients who had rhabdomyolysis following a OS overdose.
KEYWORD
Doxylamine succinate, Rhabdomyolysis, Creatine kinase
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