title: [Successful treatment of flecainide (Tambocor) poisoning--effect of hemodialysis/hemoperfusion?].
abstract: After suicidal ingestion of 3 g flecainide a 34-year-old woman showed somnolence, cerebral convulsion, disturbances of atrioventricular and intraventricular conduction and ventricular asystole. The maximum flecainide plasma level was 4900 ng/ml; this level is extremely high and exceeds the maximum therapeutic level by five times. After initial cardiopulmonary resuscitation and stabilization by intensive care treatment we performed a combined hemodialysis/hemoperfusion therapy (with activated charcoal). This procedure led to a rapid decrease of flecainide plasma levels and simultaneous improvement of ECG-alterations. The initial decrease in flecainide plasma levels during extracorporeal elimination occurred much quicker (4.5-8.5 h plasma halflife) than the spontaneous decrease rate of flecainide in humans (12-20 h plasma half-life). We conclude that, perhaps, hemodialysis/hemoperfusion therapy is an efficient method for decreasing toxic plasma levels of flecainide and for improvement of the clinical course of this intoxication.
authors.affiliation: Medizinische Klinik und Poliklinik, Klinikum der Universität (GHS), Essen.
authors.forename: E
authors.initials: E
authors.lastname: Dirks
authors.forename: B
authors.initials: B
authors.lastname: Gieshoff
authors.forename: R
authors.initials: R
authors.lastname: Stahlmann
authors.forename: M
authors.initials: M
authors.lastname: Wehr
authors.forename: W
authors.initials: W
authors.lastname: Hager
mesh_terms: D000328:Adult; D062787:Drug Overdose / Q000097:blood / Q000628:therapy*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000493:pharmacokinetics / Q000506:poisoning*; D006323:Heart Arrest / Q000139:chemically induced; D006464:Hemoperfusion; D006801:Humans; D006435:Renal Dialysis; D013406:Suicide, Attempted
chemical_list: D005424:Flecainide
vernacular_title: Erfolgreiche Therapie einer Flecainid-(Tambocor-)Intoxikation--Effekt einer Hämodialyse/Hämoperfusion?