Dialysis of Poisons and Drugs

Schreiner, George E.

doi:10.1177/106002807100501005

Cited by 11 publications

(4 citation statements)

References 206 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the first review of the role of hemodialysis in acute poisoning in 1958, Schreiner (3) listed 15 drugs that would be amenable to dialysis. This number rose to 29 dialyzable poisons in 1960 (37) and further to 55 drugs in the first of the classic reviews of dialysis and poisoning in 1963 (4). Be- Often this will include hypotension despite fluid replacement, apnea, or severe hypothermia, or a combination of these findings.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Artificial Organs: Extracorporeal Removal of Drugs

Winchester

1986

Artificial Organs

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Evolution of Artificial Organs: Extracorporeal Removal of Drugs

Winchester

1986

Artificial Organs

View full text Add to dashboard Cite

“…This effect can be explained on the basis of the square meter hour hypothesis of Scribner and Maher (9), which states that the dialysis of substances with molecular weights ranging from 350 to 2,000, the so-called "middle" molecules, …”

Section: Discussionmentioning

confidence: 99%

Effects of Renal Failure and Dialysis on Cefazolin Pharmacokinetics

Madhavan

Yaremchuk

Levin

et al. 1975

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Serum and urinary levels of cefazolin were determined after a 500-mg parenteral dose in eight azotemic volunteers. The mean peak serum concentration was 1.5 to 5 times the levels obtained in nonazotemic patients. The serum half-life of cefazolin was increased significantly. In patients on dialysis, the mean serum half-life of cefazolin was 4.05 h during (or after) hemodialysis, and 32.1 h during (or after) peritoneal dialysis. There was a significant decrease in cefazolin removal when dialysate flow or membrane surface area of the dialyzer were decreased. It was also shown that one circuit through the dialysis unit caused measurable decrease in cefazolin concentration. These data and previously published reports suggest: (i) the maintenance dose of cefazolin can be decreased in azotemic patients; (ii) patients on hemodialysis will require an additional half dose after dialysis because of efficient removal during hemodialysis; and (iii) patients on peritoneal dialysis do not require an extra dose.Cefazolin, a recently introduced cephalosporin antibiotic, was reported not to be nephrotoxic in recent clinical studies (2, 6, 7). However, this antibiotic produced higher serum levels in uremic than in nonazotemic patients. It was also noted that the serum half-life of cefazolin was reduced by hemodialysis, but was little affected by peritoneal dialysis (1, 3, 5). We have confirmed these results in patients with varying degrees of renal failure and in patients undergoing peritoneal and hemodialysis. We also studied the pharmacokinetics of cefazolin using standard 4-h large-surface-area (2.4 m2) hemodialysis, hemodialysis with reduced membrane surface area, and also the effects of reduced duration of dialysis. MATERIALS AND METHODSEighvruremic patients not on dialysis were given 500 mg of cefazolin as a single intramuscular injection. Serum and urine samples were collected before the injection and at 0.5, 1, 4, 8, 12, and 24 h after administration of the drug.Ten patients on dialysis were divided into three groups. Four patients in Group I were given 1 g of cefazolin intravenously at the initiation of a 4-h hemodialysis by using two Cordis Dow Model no. 4 hollow fiber kidneys. Blood flow during dialysis was approximately 200 ml/min, and dialysate flow was 500 ml/min. Blood samples were collected serially from venous dialysis lines without anticoagulant, and aliquots of 20 ml were taken from the dialysate for cup-plate assay.

show abstract

“…Istnieją również doniesienia o próbach eliminacji pozaustrojowej aniliny w procedurze hemodializy [14,15]. Właściwości fizyko -chemiczne aniliny i jej metabolitów (molekuły o małej masie cząsteczkowej) wskazywałyby na użyteczność hemodializy jako metody eliminacji substancji toksycznej [14].…”

Section: Rycunclassified

Accidental severe poisoning with methemoglobinogenic substance: A case report

Rośniak-Bąk

Bąk

Winnicka

et al. 2017

Med Pr

View full text Add to dashboard Cite

StreszczenieDo regionalnego ośrodka zatruć (ROZ) przyjęto 45-letniego pacjenta z powodu omyłkowego zatrucia pochodną dimetyloaniliny w miejscu pracy. Substancja toksyczna trafiła do organizmu drogą doustną. Podczas hospitalizacji podstawowym sposobem leczenia było podawanie błękitu metylenowego jako klasycznej odtrutki stosowanej w takim przypadku. W trakcie intensywnej opieki i leczenia u pacjenta zaobserwowano masywną hemolizę wewnątrznaczyniową, wymagającą leczenia preparatami krwiopochodnymi, oraz cechy uszkodzenia wątroby w postaci cholestatycznego uszkodzenia wątroby i żółtaczki. W Klinice Toksykologii pacjent przebywał 3 tygodnie. Opisany przypadek wskazuje na możliwość wystąpienia ciężkich powikłań narządowych w przebiegu zatrucia nawet niewielką ilością substancji chemicznej. Med. Pr. 2017;68(6):795-801 Słowa kluczowe: zatrucia, uszkodzenie wątroby, błękit metylenowy, dimetyloanilina, hemoliza, żółtaczka AbstractA 45-year-old male patient was admitted to the Regional Poison Center because of poisoning with dimethyloaniline contained in a toxic resin-curing dimethyl aniline-based formulation ingested inadvertently. Intoxication happened at workplace. The patient was then transferred to the Toxicology Clinic, where he stayed for 3 weeks. During the hospitalization, the primary method of treatment involved administration of methylene blue, which is the antidote of choice in such cases. During the intensive care and treatment of the patient massive intravascular hemolysis was seen. In that case treatment with blood products was required. He also showed signs of liver dysfunction due to cholestatic liver damage and jaundice. The reported case shows that severe organ damage may result from poisoning with even a small amount of the toxicant. Med Pr 2017;68 (6) https://doi.org/10.13075/mp.5893.00572 WSTĘPSubstancje methemoglobinotwórcze stanowią heterogenną grupę związków chemicznych. Znane są ich róż-ne klasyfikacje [1,2], jednak z punktu widzenia lekarza klinicysty najbardziej przydatnym podziałem jest rozróżnienie na substancje w bezpośrednim lub pośred-nim mechanizmie biologicznego działania. W przypadku zatrucia związkami methemoglobinotwórczymi w bezpośrednim mechanizmie działania bardzo szybko ustępują objawy sinicy i niedotlenienia, natomiast w przypadku związków wywołujących methemoglobinemię w mechanizmie pośrednim obserwowane zmiany utrzymują się przez dłuższy czas.Pochodne aniliny blokują możliwość dokomórko-wego transportu tlenu w efekcie utlenienia jonów Fe 2+

show abstract

Dialysis of Poisons and Drugs

Cited by 11 publications

References 206 publications

Evolution of Artificial Organs: Extracorporeal Removal of Drugs

Evolution of Artificial Organs: Extracorporeal Removal of Drugs

Effects of Renal Failure and Dialysis on Cefazolin Pharmacokinetics

Accidental severe poisoning with methemoglobinogenic substance: A case report

Contact Info

Product

Resources

About