Rapid Reversible Coma with Intravenous Gamma-Hydroxybutyrate in a Moxifloxacin-Treated Patient
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An adverse reaction rate of 5.0–37.0% has been reported with moxifloxacin.[1, 2, 3] The most common adverse effects are gastrointestinal reactions (nausea 8%, diarrhoea 6%, vomiting 2% and taste perversion 1%); next most common are symptoms of the central nervous system (CNS) [mostly headache 2% and dizziness 3%]; less frequent are restlessness, insomnia, sleep disorders, agitation and vision changes. More rare adverse effects of moxifloxacin include QTc prolongations, dermatological reactions, liver changes, tendon ruptures and arthropathy.
In an attempt to explain the underlying mechanism for the neurological adverse effects of quinolones, the gamma-aminobutyric acid (GABA) receptor has been proposed as a possible target for this class of antibacterials. Quinolones inhibit binding of GABA to its receptor.[2,4,5] Gamma-hydroxybutyrate (GHB), a metabolite of GABA, is a naturally occurring transmitter in the brain that plays a role in sleep regulation and affects cerebral energy...
KeywordsCarvedilol Moxifloxacin Flumazenil Mental Status Change Levothyroxine Sodium
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