A 32-year-old doctor, who tried to kill himself by taking a cocktail of drugs to trigger cardiac arrest and reduce blood glucose levels to shut off brain function, has been saved by doctors of a city hospital. The case features in the March issue of the Indian Journal of Critical Care Medicine.
The doctor reportedly told family members about the drugs he had taken after the symptoms started showing. Almost two hours after he took the drugs, he was rushed to Sir Ganga Ram Hospital.
“In my 25 years of practice, I had never seen such a toxic concoction as a method of attempted suicide. The patient had ingested 100 tablets of Digoxin. The drug is used to treat irregular heartbeats in patients, but, when taken in large doses, can lead to cardiac arrest. He injected himself with 1,600 units of insulin to drop his blood sugar levels,” Dr Sumit Ray, vice-chairperson (critical care) at the hospital, said.
The doctor also overdosed on Propranolol which slows heart and pulse rates drastically and, taken with Digoxin, can trigger cardiac arrest.
The challenge for doctors, the article states, was to find a Digoxin-specific antidote, which is not readily available in India. The imported drug is very expensive – Rs 1 lakh per vial. “We would need at least 15-20 vials. The patient’s condition was deteriorating fast. After consulting specialists, we decided to try charcoal-based hemoperfusion,” Dr Ray said.
Hemoperfusion is a process to remove toxic substances from the blood that cannot be done by dialysis. At Rs 4,500 per cartridge, it was cheaper. “There has been only anecdotal references in international literature of this method for removing Digoxin. But the levels of Digoxin reduced significantly,” he said.
Doctors brought down the Propranolol levels with Gluca-gon, a hormone. His blood sugar levels were increased with infusion of Dextrose for 68 hours. “The patient was discharged after six days when his blood profile normalised and after consultation with a psychiatrist,” Dr Ray said.