Impaired metabolism of methylphenobarbital after a combined drug overdose: treatment by resin hemoperfusion.
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.
D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D000435:Alcoholic Intoxication / Q000628:therapy*; D000437:Alcoholism / Q000150:complications; D003128:Coma / Q000139:chemically induced* / Q000628:therapy; D004347:Drug Interactions; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D008618:Mephobarbital / Q000378:metabolism* / Q000506:poisoning; D011137:Polystyrenes / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000628:therapy; D013406:Suicide, Attempted
D011137:Polystyrenes; D000082:Acetaminophen; D008618:Mephobarbital; C003771:Amberlite XAD-2 resin