Baclofen toxicity

Background

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

Clinical Features

  • nausea and vomiting
  • Drowziness, dizziness
  • Seizures, delirium, altered mental status, coma
  • Bradycardia, hypotension OR hypertension, respiratory compromise
  • Hypothermia

Differential Diagnosis

Evaluation

  • 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

Disposition

See Also

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