Overdose of No-shpa
No-shpa (drotaverine hydrochloride) is a drug with a pronounced antispasmodic effect. It relaxes the smooth muscles of the genitourinary organs, biliary tract and the digestive system. When taking tablets in a therapeutic dose, No-shpa has a slight effect on the state of the myocardium and the smooth muscle membrane of the blood vessels. With the injection route of administration, it has a pronounced effect on the cardiovascular system, leading to a slowdown in the heart rate and a decrease in blood pressure.
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No-shpu is used in the complex therapy of pain syndrome caused by muscle spasms for the following diseases:
- peptic ulcer of the stomach and duodenum;
- gastritis;
- colitis;
- enteritis;
- pancreatitis;
- irritable bowel syndrome;
- flatulence;
- renal colic;
- hepatic colic;
- algodismenorrhea;
- threatening spontaneous miscarriage.
Drotaverine hydrochloride has been used in medical practice since 1961 and is considered one of the safest and most effective antispasmodics. The drug can be purchased from any pharmacy without a prescription. Nevertheless, despite the low toxicity, taking No-shpa in high doses can lead to an overdose with dangerous health consequences.
How much No-shpa is needed for an overdose?
The maximum daily dose of No-shpa depends on age. So, for children of the first year of life, it is 40-120 mg, at the age of 1-6 years - 80-200 mg, for adults the maximum daily dose should not exceed 240 mg (6 tablets). Exceeding the indicated daily doses may cause overdose.
Severe overdose, leading to death, occurs if at least 40-60 tablets (1.6-2.4 g) are taken. It is impossible to take such a dose by accident, as a rule, this is a consequence of suicidal attempts. Cases of severe overdose of No-shpa in children have not been described. This is most likely due to the bitter taste of the tablets.
Signs of overdose
For a mild overdose, No-shpa is characterized by:
- nausea;
- headache;
- palpitations;
- lowering blood pressure;
- constipation.
Such symptoms do not require treatment; after discontinuation of the drug, they disappear on their own within 1-2 days.
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Otherwise, the clinical picture of a severe overdose manifests itself:
- arrhythmia caused by a violation of electrical conduction (including complete blockade of the bundle branch);
- severe nausea;
- repeated vomiting;
- violation of coordination of movements;
- tremor of the limbs;
- seizures;
- loss of consciousness.
Violations of the conduction of an electrical impulse along the pathways of the myocardium can cause cardiac arrest and death.
First aid for overdose No-shpa
In case of mild overdose, it is necessary:
- Stop further taking the drug.
- Take 4-5 tablets of activated charcoal or any other enterosorbent.
In case of severe overdose, if the victim is conscious:
- Rinse the stomach: drink 1 liter of water, then, irritating the root of the tongue, provoke vomiting. Repeat 2-3 times. Gastric lavage is done if no more than 1 hour has passed since taking the pills.
- Take any enterosorbent. For example, Smectu (2 sachets) or Activated carbon (2 tablets per kilogram of body weight).
If the victim is unconscious:
- Lay on its side, preventing the tongue from sinking and the aspiration of vomit.
- Provide fresh air by removing or loosening tight clothing and opening a window.
- When signs of cardiac and respiratory arrest (lack of pulse and respiration) appear, carry out resuscitation measures (artificial respiration and indirect heart massage) until spontaneous breathing and heartbeat are restored, or before the arrival of an ambulance team.
Antidote
There is no specific antidote to No-shpe.
When is medical attention needed?
Medical assistance is needed in cases of severe overdose of No-shpa. In the absence of specialized care, the victims die within a few hours after taking the drug inside, which is explained by the high rate of absorption of No-shpa from the gastrointestinal tract and its bioavailability, which reaches almost 100%.
The injured are hospitalized in the intensive care unit of the toxicological center. Compulsory round-the-clock medical supervision, including monitoring of heart rate, respiration, blood pressure. The patient is connected to a cardiac monitor, an electrocardiogram is recorded.
Symptomatic treatment aimed at maintaining vital body functions, including:
- antiarrhythmic therapy;
- with an increase in respiratory failure - tracheal intubation and artificial ventilation.
Possible consequences
The prognosis for a severe overdose of No-shpy is serious. Severe heart rhythm disturbances and a state of clinical death often cause damage to the tissues of the brain, liver and kidneys with the formation of functional failure of these organs. Even timely and adequate treatment does not in all cases allow achieving their full recovery in the future.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
