Impaired metabolism of methylphenobarbital after a combined drug overdose: treatment by resin hemoperfusion.

Abstract

A 38-yr-old woman who by history ingested 13 g methylphenobarbital, alcohol, and 6 g acetaminophen became comatose slowly over 4 d. Acute hepatic injury appeared to impair the oxidative N-demethylation of methylphenobarbital to its product, phenobarbital. On the eighth day after ingestion she was treated because of protracted coma with Amberlite XAD-4 resin hemoperfusion. Hemoperfusion, which removed 0.83 g methylphenobarbital and 2.10 g phenobarbital, led to transient clinical improvement. When supportive patient management fails to produce a satisfactory clinical course in a methylphenobarbital-intoxicated patient, hemoperfusion could be a useful adjunct to therapy.

• Authors: S Pond, P Jacob 3rd, M Humphreys, R Weiss, T Tong
• Journal: Journal of toxicology. Clinical toxicology (J Toxicol Clin Toxicol) Vol. 19 Issue 2 Pg. 187-96 (Apr 1982) ISSN: 0731-3810 [Print] United States
• PMID: 7109008 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Polystyrenes
• Acetaminophen
• Mephobarbital
• Amberlite XAD-2 resin

Topics

• Acetaminophen (poisoning)
• Adult
• Alcoholic Intoxication (therapy)
• Alcoholism (complications)
• Coma (chemically induced, therapy)
• Drug Interactions
• Female
• Hemoperfusion
• Humans
• Mephobarbital (metabolism, poisoning)
• Polystyrenes (therapeutic use)
• Substance-Related Disorders (therapy)
• Suicide, Attempted