| Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem. | |
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MedLine Citation:
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PMID: 18582256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effect of charcoal haemoperfusion on the pharmacokinetics of diltiazem is described in a patient with severe clinical toxicity following acute overdose. The patient presented within 3 h following acute ingestion of multiple medications including sustained-release diltiazem. Routine resuscitation and supportive care were administered, but hypotension did not resolve despite intravenous fluids and infusions of calcium, adrenaline, noradrenaline and vasopressin. Multiple-doses of activated charcoal, haemodialysis and charcoal haemoperfusion were prescribed to expedite the elimination of diltiazem. The maximum diltiazem concentration (577 microg.l(-1)) was recorded 7 h post ingestion which was followed by an erratic and prolonged elimination phase. The maximum clearance of diltiazem due to haemoperfusion was calculated to be 19.4 and 15.1 ml.min(-1) at different times, equating to removal of approximately 1.5 mg diltiazem during 4 h of haemoperfusion. Haemoperfusion did not appear to remove sufficient diltiazem to recommend its routine use in the treatment of patients with acute diltiazem overdose. |
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Authors:
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D M Roberts; J A Roberts; R J Boots; R Mason; J Lipman |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anaesthesia Volume: 63 ISSN: 1365-2044 ISO Abbreviation: Anaesthesia Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-06-27 Completed Date: 2008-07-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370524 Medline TA: Anaesthesia Country: England |
Other Details:
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Languages: eng Pagination: 714-8 Citation Subset: AIM; IM |
Affiliation:
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Burns, Trauma and Critical Care Research Centre, University of Queensland, Butterfield Street, Herston, Australia. 1darren1@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Antihypertensive Agents / blood, poisoning Calcium Channel Blockers / blood, poisoning Charcoal Delayed-Action Preparations Diltiazem / blood*, poisoning* Hemoperfusion* Humans Male Overdose / blood, therapy Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Delayed-Action Preparations; 16291-96-6/Charcoal; 42399-41-7/Diltiazem |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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