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Home > Emergency Medical Minute > Episode 944: Colchicine Oversode
Podcast: Emergency Medical Minute
Episode:

Episode 944: Colchicine Oversode
Category: Science & Medicine
Duration: 00:03:19
Publish Date: 2025-02-17 11:00:00
Description:

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

  1. 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.

  2. 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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