Contributor: Aaron Lessen, MD
Educational Pearls:
Colchicine is most commonly used for the prevention and treatment of gout
There is research investigating the anti-inflammatory and cardioprotective effects of colchicine
This drug has a narrow therapeutic index: a small margin between effective dose and toxic dose
Colchicine overdoses can be unintentional or intentional and are associated with poor outcomes
Phase 1: 10 - 24 hours after ingestion
Patient looks well but may have mild symptoms mimicking gastroenteritis
Phase 2: 24 hours - 7 days after ingestion
Multiple organ dysfunction syndrome (MODS)
Phase 3: recovery is usually within a few weeks of ingestion
Treatment for colchicine overdose
Treat early and aggressively
Gastrointestinal decontamination with activated charcoal and orogastric lavage
Dialysis and ECMO for MODS treatment
References
Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, Nguyen P, Dubnov-Raz G, Pollak U, Koren G, Bentur Y. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila). 2010 Jun;48(5):407-14. doi: 10.3109/15563650.2010.495348. PMID: 20586571.
Gasparyan AY, Ayvazyan L, Yessirkepov M, Kitas GD. Colchicine as an anti-inflammatory and cardioprotective agent. Expert Opin Drug Metab Toxicol. 2015;11(11):1781-94. doi: 10.1517/17425255.2015.1076391. Epub 2015 Aug 4. PMID: 26239119.
Summarized by Meg Joyce, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS3
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