II. Sources
III. Pharmacokinetics: Toxicity
- Oral Bioavailability: 80%
- Toxic Doses
- Toxicity within hours to days of large ingestion
- Hepatic metabolism
- Excreted in feces and urine
IV. Findings
- Gastrointestinal
- Neurologic
- Pseudotumor Cerebri (intracranial Hypertension)
- Headache
- Blurred Vision
- Papilledema
- Endocrine
- Hypercalcemia (chronic ingestion)
- Skin (late finding)
- Skin Desquamation
- Alopecia
V. Labs
- See Unknown Ingestion
- Comprehensive metabolic panel (including serum Electrolytes, Serum Calcium, Liver Function Tests)
-
Lumbar Puncture
- Indicated in suspected Pseudotumor Cerebri or Altered Level of Consciousness
VI. Management
- See Unknown Ingestion
- Evaluate all ingestions >300,000 IU
-
Activated Charcoal
- Indicated if ingestion in last 1-2 hours and patient able to control airway, Emesis
- Supportive care
- Hypercalcemia management as needed
- Observe symptomatic patients
- Intracranial Hypertension
VII. References
- Tomaszewski (2023) Crit Dec Emerg Med 37(12): 32