Document Detail


Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem.
MedLine Citation:
PMID:  18582256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
D M Roberts; J A Roberts; R J Boots; R Mason; J Lipman
Related Documents :
1378136 - A comparison of carvedilol with a combination of propranolol and isosorbide dinitrate i...
428106 - Circadian variation of exercise capacity in patients with prinzmetal's variant angina: ...
16628416 - Improved systemic safety and risk-benefit ratio of topical 0.1% timolol hydrogel compar...
9013266 - Nifedipine gastrointestinal therapeutic system versus atenolol in stable angina pectori...
22076266 - Tissue oximetry: a comparison of mean values of regional tissue saturation, reproducibi...
8098276 - Short-term effects of denopamine on anaerobic threshold and related parameters in patie...
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  63     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-27     Completed Date:  2008-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  714-8     Citation Subset:  AIM; IM    
Affiliation:
Burns, Trauma and Critical Care Research Centre, University of Queensland, Butterfield Street, Herston, Australia. 1darren1@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
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


Previous Document:  Predicting adverse outcomes of cardiac surgery with the application of artificial neural networks.
Next Document:  Effect of magnesium sulphate on urinary catecholamine excretion in severe tetanus.