Suicide attempt using potassium tablets for congenital chloride diarrhea: A case report

Table 1 Cases of suicidal poisonings associated with an oral intake of slow-release potassium chloride

Ref.	Age/Sex	Underlying disease	Psychiatric disorder	Amount of K ingested	Time (h) from ingestion to arrival at ED	Peak serum K level (mmol/L)	Symptoms	ECG findings	Treatment	Outcome
Illingworth et al[15], 1980	36/M	Hypertension treated with thiazide diuretic	NR	Unknown	5	8.9	Vomoting	Wide QRS complex, hyperacute T-waves, short runs of ventricular tachycardia	Calcium gluconate, sodium bicarbonate, insulin/glucose, frusemide, ion exchange resin	Survived
Illingworth et al[15], 1980	58/F	Hypertension treated with thiazide diuretic	NR	20 T/168 mmol	5	9.1	Vomiting, sweating, breathlessness, cyanosis	Hyperacute T-waves, left bundle-branch block	Insulin/glucose, frusemide, gastric lavage, ion exchange resin	Survived
Illingworth et al[15], 1980	59/F	NR	NR	40 T/320 mmol	3.5	9.3	Vomit, cardiac arrest	Asystole	Gastric lavage	Died
Saxena[4], 1988	46/F	NR	Depression	100 T/800 mmol	1	9.6	Cardiac arrest	NR	Calcium gluconate, sodium bicarbonate, insulin/glucose, gastric lavage, activated charcoal, cathartic	Died
Steedma[16], 1988	27/F	Hypokalemia due to anorexia	Anorexia nervosa	60 T/480 mmol	12	9.1	Cyanosis, cold extremities, poor peripheral pulse	1st degree heart block, wide QRS complex, hyperacute T-waves	Calcium gluconate, sodium bicarbonate, insulin/glucose, ion exchange resin	Survived
Colledge et al[17], 1988	24/M	NR	NR	100 T/800 mmol	2	7.9	Vomiting	Hyperacute T-waves, sinus tachycardia, ventricular tachycardia	Calcium gluconate, sodium bicarbonate, insulin/glucose, gastric lavage, ion exchange resin	Survived
Peeters et al[18], 1998	62/F	NR	Depression	300 T/2400 mmol	NR	NR	Abdominal distention	NR	Endoscopic removal	Survived
Su et al[19], 2001	50/F	Hypertension	Anxiety disorder, depression	100 T/1000 mmol	1	9.7	Cramping abdominal pain, tachycardia	Hyperacute T-waves	Calcium chloride, sodium bicarbonate, insulin/glucose, gastric lavage, whole bowel irrigation, hemodialysis	Survived
	17/F	None	None	30 T/300 mmol	10	6.1	Nausea, vomiting, diarrhea	Tachycardia	Whole bowel irrigation	Survived
Wan et al[20], 2007	86/M	Hypertension treated with thiazide diuretic	Dementia	70 T/560 mmol	NR	6.8	Unknown	No feature of hyperkalemia	Calcium gluconate, sodium bicarbonate, insulin/glucose	Survived
Höjer et al[21], 2008	28/F1		Unknown disease with pacemaker in situ	Borderline personality disorder	100 C/1000 mmol	3	9.2	Cardiac arrest	Pacemaker capture	Calcium gluconate, sodium bicarbonate, insulin/glucose, gastric lavage, activated charcoal, ion exchange resin, hemodialysis	Survived
	28/F1	Unknown disease with pacemaker in situ	Borderline personality disorder	100 C/1000 mmol	1	6.9	Cardiac arrest	Pacemaker rhythm	Calcium gluconate, sodium bicarbonate, insulin/glucose, gastric lavage, activated charcoal, ion exchange resin	Survived
	28/F1	Unknown disease with pacemaker in situ	Borderline personality disorder	70 C/700 mmol	2.5	7.1	NR	Hyperacute T-waves	Sodium bicarbonate, insulin/glucose, ion exchange resin	Survived
Bosse et al[22], 2011	56/F	NR	Depression	60 T/480 mmol	5	11	Lethargy	Complex sine-wave rhythm	Calcium gluconate, sodium bicarbonate, insulin/glucose	Survived
Gunja[23], 2011	42/F2	NR	Bipolar disorder	40 T/320 mmol	1.5	5.5	NR	Sinus tachycardia, tall T-waves	Insulin, whole bowel irrigation	Survived
	42/F2	NR	Bipolar disorder	100 T/800 mmol	5	8.5	Tachycardia	Sinus tachycardia, tall T-waves	Calcium chloride, sodium bicarbonate, insulin, hemodialysis	Survived
Nilsson et al[24], 2012	30/F	NR	Depression	300 T/3000 mmol	5	10.3	Drowsiness, daze	Sine-wave tachycardia	Calcium gluconate, sodium bicarbonate, insulin/glucose, gastric lavage, ion exchange resin, hemodialysis, surgical removal	Survived
Guillermo et al[25], 2014	42/F	NR	Borderline personality disorder	100 T/800 mmol	2	3.9	Somnolence	Sinus tachycardia	Gastric lavage, activated charcoal, endoscopic removal	Survived
Briggs et al[26], 2014	44/F	Hypokalemia	Anxiety disorder	30 T/600 mmol	1.25	7.3	NR	Mildly peaked T-waves	Calcium gluconate, sodium bicarbonate, insulin/glucose, whole bowel irrigation, ion exchange resin, endoscopic removal	Survived

^1,2: Same patient, respectively; C: Capsule; ECG: Electrocardiogram; ED: Emergency department; F: Female; K: Potassium; M: Male; NR: Not reported; T: Tablet.