PharmacyPharmacologyToxicologyPharmaceutical ToxicologyPoisoning DiagnosisPoisoning ManagementAcute Liver FailureAcute ToxicityDrug Overdose DiagnosisDrug Overdose ManagementOverdose ManagementToxicologic EmergenciesAcute Organ FailureAcute Upper Gastrointestinal BleedingCholestasis PathophysiologyCholestasis ResolutionMedication Poisoning AssessmentOverdose Syndromes
A male patient ingested a single overdose of ibuprofen (greater than 20 g). The serum ibuprofen levels were 185 mg/L (897 mumol/L) and 51.6 mg/L (250 mumol/L) at ten hours and 67 hours, respectively, after ingestion. There was also an accumulation of metabolites (2-carboxyibuprofen and 2-hydroxyibuprofen) in the plasma. The patient became unresponsive and developed severe metabolic acidosis, acute renal failure, acute liver-cell injury, acute cholestasis, and thrombocytopenia. Although his course was complicated by respiratory failure, hypotension, and upper gastrointestinal tract bleeding, the patient had complete resolution of multiple organ failure.