Baclofen toxicity

Background

• Indications include MS, muscle spasticity pain
• GABAb receptor agonist
• Most excretion is renal

Clinical Features

• N/V
• Drowziness, dizziness
• Seizures, delirium, AMS, coma
• Bradycardia, hypotension OR HTN, respiratory compromise
• Hypothermia

Diagnosis

• Diagnosis of exclusion

Management

• Activated charcoal for recent ingestion
• Supportive care:
  • IV fluids, respiratory care
  • Vasopressors for persistent hypotension
  • Benzodiazepines for seizures
• Hemodialysis for very severe toxicity

References

• Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.
• Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82