NEAL L. BENOWITZ, M.D.; RANDY BYRD, M.D.; MORRIS SCHAMBELAN, M.D.; JON ROSENBERG, M.D.; MICHAEL F. ROIZEN, M.D.
We report a case of severe orthostatic hypotension after ingestion of the rodenticide Vacor (Rohm and Haas Co., Philadelphia, Pennsylvania) in which hypotension remained incapacitating despite usual medical management. Dihydroergotamine remarkably improved postural blood pressure responses and enabled the patient to ambulate and care for himself.
In a suicide attempt a 32-year-old man ingested one packet of Vacor (39 g, 2% N-3-pyridylmethyl-N'-p-nitrophenylurea). Shortly after ingestion he was hospitalized with hyperglycemic ketoacidosis, which was treated with insulin and fluids, and orthostatic hypotension was noted. Orthostatic syncope persisted over the next month despite treatment with lower extremity stockings and fludrocortisone, 0.3 mg/d,
BENOWITZ NL, BYRD R, SCHAMBELAN M, ROSENBERG J, ROIZEN MF. Dihydroergotamine Treatment for Orthostatic Hypotension from Vacor Rodenticide. Ann Intern Med. ;92:387–388. doi: 10.7326/0003-4819-92-3-387
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Published: Ann Intern Med. 1980;92(3):387-388.
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