Abstract
Background
Lacosamide is a third-generation antiepileptic drug. Its likely mechanism of action
is via neuronal sodium channel blockade, via a unique manner compared with other antiepileptic
drugs that block sodium channels. A paucity of information exists regarding lacosamide
overdosage. Lacosamide overdosage is thought to cause QRS prolongation and seizures,
due to its effect of sodium channel blockade. The potential efficacy of sodium bicarbonate
to reverse the effects of lacosamide has not been well studied. Furthermore, prior
reports of lacosamide toxicity have occurred in the setting of concomitant polypharmacy.
Thus, the isolated toxic effects of the drug have not been well elucidated.
Case Report
We report a case of a suspected, single-ingestion overdose on lacosamide. The patient
developed signs of cardiotoxicity and seizure.
Why Should an Emergency Physician Be Aware of This?
After lacosamide overdosage, the emergency physician must be capable of acute management
of subsequent lacosamide toxicity. Understanding the mechanisms of action causing
toxicity due to this drug can help the clinician to anticipate the interventions that
may be needed or useful to treat this potentially toxic ingestion.
Keywords
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Article info
Publication history
Published online: March 14, 2019
Accepted:
January 17,
2019
Received in revised form:
January 4,
2019
Received:
October 30,
2018
Footnotes
There is no prior publication, conflict of interest, or copyright constraint. These data have not been published as a peer-reviewed article previously, and are not under consideration for publication by another journal. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the U.S. Air Force, Department of Defense, or the U.S. government.
Identification
Copyright
Published by Elsevier Inc.
