Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem

D. M. Roberts, J. A. Roberts, R. J. Boots, R. Mason and J. Lipman (2008) Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem. Anaesthesia, 63 7: 714-718. doi:10.1111/j.1365-2044.2008.05477.x


Author D. M. Roberts
J. A. Roberts
R. J. Boots
R. Mason
J. Lipman
Title Lessons learnt in the pharmacokinetic analysis of the effect of haemoperfusion for acute overdose with sustained-release diltiazem
Journal name Anaesthesia   Check publisher's open access policy
ISSN 0003-2409
Publication date 2008-07-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1365-2044.2008.05477.x
Open Access Status
Volume 63
Issue 7
Start page 714
End page 718
Total pages 5
Editor Dr D Bogod
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd
Language eng
Subject C1
920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
110310 Intensive Care
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 mu g.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.
Keyword Anesthesiology
Anesthesiology
ANESTHESIOLOGY
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 16 Apr 2009, 00:40:35 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH