Ethchlorvynol in biological fluids: Specificity of assay methods

Gibson, P.F.; Wright, N.

doi:10.1002/jps.2600610204

Cited by 13 publications

(2 citation statements)

References 20 publications

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“…Log-linear decline of ECY after an overdose has also been described"; however, the drug was measured using a nonspecific assay, which also measures ECY metabolites. As we and others have observed, renal clearance of ECY is quite small and makes an inconsequential contribution to overall drug removal.v 4,15 The Amberlite XAD-4 resin extracted more than 99% of ECY from plasma, so that clearance was essentially equal to blood flow. The cartridge has a high affinity for EC Y, so that high clearances can be maintained for several hours.…”

Section: Discussionmentioning

confidence: 90%

Resin hemoperfusion in ethchlorvynol overdose

Benowitz

Abolin

Tozer

et al. 1980

Clin Pharmacol Ther

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An 18-yr-old male with a severe ethchlorvynol (ECV) overdose was treated with Amberlite XAD-4 resin hemoperfusion. Plasma ECV concentration declined 33% during a 3.5-hr hemoperfusion, but rebounded substantially, peaking 6 hr later. It was estimated that 16% of ECV in the body was removed. Following hemoperfusion, plasma ECV concentrations declined linearly at a rate of 13 mg/1/day. Hemoperfusion clearance was estimated by both the traditional method, using extraction ratios across the column and column blood flow (Cl = 270 ml/min), and an alternative method, using blood concentrations during hemoperfusion and recovery of drug from the resin (Cl = 184 ml/min). The latter may provide a better estimate of hemoperfusion clearance because it is not subject to error (which can be substantial) in measurement of column blood flow. The resin completely extracted ECV from plasma, resulting in a rate of elimination 10 times that expected from endogenous processes. To aid in kinetic analysis, blood:plasma partition and protein binding of ECV in 3 normal subjects were also examined. Blood:plasma ratio averaged 0.88 +/- 0.04 and fraction free in plasma, 0.38 +/- 0.02; neither changed as a function of blood concentration between 27 and 108 mg/1. Our data indicate that removal of ECV from the overdosed patient by hemoperfusion is limited by extensive distribution in and slow redistribution from body tissues, but because of the extremely slow rate of removal by the body and the severe nature of the ECV overdose, Amberlite XAD-4 hemoperfusion may be clinically useful.

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Section: Discussionmentioning

confidence: 90%

Resin hemoperfusion in ethchlorvynol overdose

Benowitz

Abolin

Tozer

et al. 1980

Clin Pharmacol Ther

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“…The horizontal bars indicate the period of dialysis. [Adapted with permission of the copyright owners from Amdisen and Skjoldborg (1969) and Gibson and Wright (1972). ]…”

Section: Route Of Drug Eliminationmentioning

confidence: 99%

Drug Therapy in Patients Undergoing Haemodialysis

Lee

Marbury

1984

Clinical Pharmacokinetics

105

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Haemodialysis is utilised therapeutically as supportive treatment for end-stage renal disease (ESRD). In conjunction with haemodialysis therapy, ESRD patients frequently receive a large number of drugs to treat a multitude of intercurrent conditions. Because of the impaired renal function in ESRD patients, dosage reduction is often recommended to avoid adverse drug reactions, particularly for drugs and active metabolites with extensive renal excretion. On the other hand, if the removal of a drug by haemodialysis during concomitant drug therapy is significant, a dosage supplement would be required to ensure adequate therapeutic efficacy. Knowledge of the impact of haemodialysis on the elimination of specific drugs is therefore essential to the rational design of the dosage regimen in patients undergoing haemodialysis. This review addresses the clinical pharmacokinetic aspects of drug therapy in haemodialysis patients and considers: (a) the effects of ESRD on the general pharmacokinetics of drugs; (b) dialysis clearance and its impact on drug and metabolite elimination; (c) the definition of dialysability and the criteria for evaluation of drug dialysability; (d) pharmacokinetic parameters which are useful in the prediction of drug dialysability; and (e) the application of pharmacokinetic principles to the adjustment of dosage regimens in haemodialysis patients. Finally, drugs commonly associated with haemodialysis therapy are tabulated with updated pharmacokinetics and dialysability information.

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Limitations of Haemodialysis and Forced Diuresis

Prescott

1974

Novartis Foundation Symposia

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Ethchlorvynol in biological fluids: Specificity of assay methods

Cited by 13 publications

References 20 publications

Resin hemoperfusion in ethchlorvynol overdose

Resin hemoperfusion in ethchlorvynol overdose

Drug Therapy in Patients Undergoing Haemodialysis

Limitations of Haemodialysis and Forced Diuresis

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