| Title | Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem. | | Author(s) | Roberts DM, Roberts JA, Boots RJ, Mason R, Lipman J | | Institution | Burns, Trauma and Critical Care Research Centre, University of Queensland, Butterfield Street, Herston, Australia. 1darren1@gmail.com | | Source | Anaesthesia 2008 Jul; 63(7):714-8. | | MeSH | Acute Disease
Adult
Antihypertensive Agents
Calcium Channel Blockers
Charcoal
Delayed-Action Preparations
Diltiazem
Hemoperfusion
Humans
Male
Overdose
Treatment Outcome
| | Abstract | 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. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 18582256 |
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