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Principles of Critical Care, 3e
| Part VIII. Renal and Metabolic Disorders > |
Levothyroxine Overdose
Topics Discussed: thyroid disorders; thyroxine.
Excerpt:
"Levothyroxine (L-T4) is dispensed commonly and, in the United States, is the fourth most frequently prescribed drug in the 3.05 billion prescriptions written in 2002 (
http://www.rxlist.com/top200.htm
). This wide availability leads to frequent overdoses, with reports of 2000 to 5000 acute toxic exposures annually in this country.73–75 Despite the high frequency of overdosage, with documented blood levels of T4 up to 16 times normal, there have been no reported deaths from L-T4 ingestion.74 Clearly, patients do become symptomatic, with tachycardia, nervousness, diarrhea, and even seizures, but these symptoms generally are self-limited. In patients suspected (but denying) of having ingested thyroid hormone, the finding of a suppressed serum thyroglobulin level in the presence of a high serum T4 and/or T3 level is diagnostic.76..."
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