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Colchicine is a drug used for the treatment of acute gout attacks. It inhibits microtubule formation vital for cellular mitosis. It is also a drug with a narrow therapeutic index and lethal toxicity:
- Colchicine can be lethal at 0.5 mg/kg or even lower. Though this would be about 50 tablets and seems alot, remember it is prescribed 2 tablets initially then every hour until diarrhea presents (i.e. preliminary toxicity)
- Toxicity presents in 3 stages:
- 0-24hrs: Nausea, vomiting, diarrhea
- 1-7days: Sudden cardiac death, pancytopenia, renal failure, ARDS
- >7days: Alopecia, myopathy, neuropathy (if they survive)
- No antidote, supportive care only available.
- Presentation is similiar to that of a radiation exposure