Phytonadione Therapy in a Multiple-Drug Overdose Involving Warfarin

Duane Bates, B.Sc.(Pharm.), and Marcy Mintz, M.D.

Disclosures

Pharmacotherapy. 2000;20(10) 

In This Article

Zopiclone

Zopiclone is a cyclopyrrolone derivative hypnotic agent with pharmacologic effects similar to those of benzodiazepines.[2] It is absorbed rapidly and completely with peak serum levels occurring within 30-120 minutes. Zopiclone is metabolized extensively by the liver. The elimination half-life is approximately 5 hours and is prolonged to 8 hours in severe renal failure, hepatic impairment, and the elderly. The drug is not removed by hemodialysis.[2]

The Paris Poison Control Centre received reports of 239 cases of zopiclone overdose; 66% involved women (mean age 33 yrs, range 14-80 yrs).[12] Central nervous system depression was the most frequent adverse effect. Deep coma occurred with overdoses exceeding 100 mg and/or with combinations of zopiclone and other central nervous system depressants. The agent generally does not cause any cardiovascular disorders. Of 126 patients whose outcome was known, 123 recovered without sequelae, usually within 12-48 hours. The treatment of zopiclone overdose is essentially symptomatic and supportive care.[12]

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