Intravenous Lipid Emulsion Use for Severe Hydroxychloroquine Toxicity
Symptoms related to overdose manifest rapidly because blood concentrations peak within hours. These include altered mental status, visual disturbances, seizures, ventricular dysrhythmias, hypotension, and depressed cardiac output. Patients may develop profound hypokalemia.1–3,5–7 Rebound hyperkalemia can develop as the derangement is reversed. Criteria for severe poisoning are hypotension, prolonged QRS, ventricular dysrhythmias, and severe hypokalemia.5 Greater than 4 g has been proposed as a criterion for severe HCQ overdose.