[Respective roles of gastric lavage, haemodialysis, haemoperfusion, diuresis and hepatic metabolism in the elimination of a massive meprobamate overdose (author's transl)].
A case of massive meprobamate intoxication (100 g) is reported. On admission, 8 hours later, the plasma meprobamate level was 460 mg/l. The initial shock (hours 8-12) was successfully treated with blood volume expansion and dobutamine. The plasma meprobamate level, which was 340 mg/l when haemodialysis and haemoperfusion were started, fell to 110 mg/l at the end of the treatment. Recovery was uneventful. The amounts of drug eliminated by each method were as follows: (a) gastric lavages at 8 and 26 hours: 66 g; (b) haemodialysis (18-29 hours): 8.5 g; (d) haemoperfusion on Hemopur-charcoal (20-28 hours): 7.5 g (as measured by elution); (e) diuresis (26 hours): 2 g. It may be concluded from these data that sizeable amounts of drug can be extracted by haemodialysis and haemoperfusion, that gastric lavage remains the least invasive and most rewarding method of elimination, and that the role of hepatic metabolism in detoxication has to be taken into account.
D000328:Adult; D004231:Diuresis; D005751:Gastric Lavage; D006464:Hemoperfusion; D006801:Humans; D008658:Inactivation, Metabolic; D008099:Liver / Q000378:metabolism; D008297:Male; D008620:Meprobamate / Q000378:metabolism / Q000506:poisoning*; D006435:Renal Dialysis
D008620:Meprobamate
Part respective du lavage gastrique, de l'hémodialyse, de l'hémoperfusion, de la diurèse et du métabolisme hépatique dans l'épuration du méprobamate.