Article Data

  • Views 2538
  • Dowloads 188

Case Report

Open Access

Levodopa-carbidopa-entacapone overdose presenting as altered mental status, xanthoderma, and yellowish sclera

  • SUN HWA LEE1
  • SEONG JONG YUN2
  • SEOKYONG RYU1
  • SEUNG WOON CHOI1
  • HYE JIN KIM1
  • TAE KYUNG KANG1
  • SUNG CHAN OH1
  • SUK JIN CHO1

1Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea

2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea Correspondence:

DOI: 10.22514/SV142.102018.12 Vol.14,Issue 2,November 2018 pp.75-77

Published: 02 November 2018

*Corresponding Author(s): SEONG JONG YUN E-mail: zoomknight@naver.com

Abstract

Levodopa-carbidopa-entacapone is a sin-gle combination drug consisting of levo-dopa (aromatic amino acid), carbidopa (dopa-decarboxylase inhibitor), and en-tacapone (catechol-O-methyltransferase inhibitor). The Food and Drug Admin-istration approved levodopa-carbidopa-entacapone in 2003, as treatment for idiopathic Parkinson’s disease in patients experiencing signs and symptoms of wear-ing-off. Although various adverse drug re-actions of levodopa-carbidopa-entacapone have been recorded, there has been no re-ported case of levodopa-carbidopa-entaca-pone overdose. We report the first case of signs and symptoms of an overdose of lev-odopa-carbidopa-entacapone (levodopa: 3000 mg; carbidopa: 750 mg; entacapone: 6000 mg) in a suicide attempt, presenting as altered mentality, xanthoderma, and yellowish sclera without hyperbilirubine-mia.

Keywords

levodopa-carbidopa-entaca-pone, Parkinson’s disease, drug overdose, xanthoderma, yellowish sclera, toxicology

Cite and Share

SUN HWA LEE,SEONG JONG YUN,SEOKYONG RYU,SEUNG WOON CHOI,HYE JIN KIM,TAE KYUNG KANG,SUNG CHAN OH,SUK JIN CHO. Levodopa-carbidopa-entacapone overdose presenting as altered mental status, xanthoderma, and yellowish sclera. Signa Vitae. 2018. 14(2);75-77.

References

1. Solla P, Cannas A, Marrosu F, Marrosu MG. Therapeutic interventions and adjustments in the management of Parkinson’s disease: role of combined carbidopa/levodopa/entacapone (Stalevo). Neuropsychiatr Dis Treat 2010;6:483-90.

2. Food and Drug Administration. STALEVO. http://www.accessdata.fda.gov/ drugsatfda_

3. docs/label/2003/21485_stalevo_lbl.pdf. Accessed January 3, 2017.

4. Hoehn MM, Rutledge CO. Acute overdose with levodopa. Clinical and biochemical consequences. Neurology 1975;25:792-4.

5. Sporer KA. Carbidopa-levodopa overdose. Am J Emerg Med 1991;9:47-8.

6. Stuerenburg HJ, Schoser BG. Acute overdosage and intoxication with carbidopa/levodopa can be detected in the subacute stage by measurement of 3-o-methyldopa. J Neurol Neurosurg Psychiatry 1999;67:122-3.

7. Delmas G, Rothmann C, Flesch F. Acute overdose with controlled-release levodopa-carbidopa. Clin Toxicol (Phila) 2008;46:274-7.

8. Najib J. Entacapone: a catechol-O-methyltransferase inhibitor for the adjunctive treatment of Parkinson’s disease. Clin Ther 2001;23:802-32.

9. Huang P, Yang XD, Chen SD, Xiao Q. The association between Parkinson’s disease and melanoma: a systematic review and meta-analysis. Transl Neurodegener 2015;4:21.

10. Stanley RJ, Stoecker WV, Moss RH. A relative color approach to color discrimination for malignant melanoma detection in der-moscopy images. Skin Res Technol 2007;13:62-72.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top