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Multiple organ dysfunction syndrome (MODS) in patients with chronic heart failure treated with polypharmacy – report of three cases

Katarzyna Drożdż, Anna Skoczyńska, Anna Jodkowska, Dobrosława Kwiecińska

Med Sci Tech 2007; 48(4): CR265-270

ID: 881571

Introduction: Multiple organ dysfunction syndrome (MODS) is the presence of altered organ function in a seriously ill patient such that homeostasis cannot be maintained without intervention. Usually MODS was diagnosed only in patients with sepsis, but it can also develop as the effect of many other states comprising different chemicals and drugs intoxication. Polypharmacy is first and main factor which raises MODS risk. The patients with chronic heart failure (CHF) treated with polypharmacy deserve a special attention because of their increased sensitivity to any new agent. The newly applied drug, alcohol, non-ionic contrast media (NIM) added to polypharmacy may rapidly lead to MODS. Material and methods: We describe three cases of patients with chronic heart failure treated with polypharmacy that presented features of MODS (shock, renal and liver insuffitientia, disseminated intravascular coagulation) that occurred after administration of: 1) nonionic contrast media 2) analgesics with vasodilatant drug and finally 3) alcohol. Results: The clinical symptoms of MODS have developed in the first hour after the new agents were administered. Since the third day we have observed withdrawing of all clinical symptoms and tendency of normalization in laboratory tests. Conclusions: It’s possible that patients who have once developed MODS will be more sensitive to many new agents which can very fast lead again to MODS. Understanding of the P-450 isoenzyme metabolic system is of great practical value and may help clinicians to predict and avoid drug interactions and increased risk of MODS. (Clin Exp Med Lett 2007; 48(4): 265-270)

Keywords: MODS, Polypharmacy, chronic heart failure

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