title: [Acute liver failure following tetrabamate].
abstract: Tetrabamate (Atrium), a composite preparation of phenobarbital, difebarbamate and febarbamate, is widely used to reduce ethanol withdrawal symptoms such as tremor, agitation and anxiety. Generally this drug is well tolerated and a few cases of reversible hepatitis as well as clinically mild symptoms of asthenia have been described. We report on a 28-year-old female patient admitted to hospital with acute liver failure after treatment with tetrabamate because of alcohol withdrawal symptoms. Liver biopsy revealed a drug-induced toxic alteration with extensive panlobular necrosis without signs of alcoholic hepatitis. Under supportive therapy liver parameters normalized in 3 months. In view of this potentially lethal adverse effect of tetrabamate, it should not be used for ethanol withdrawal symptoms.
authors.affiliation: Departement für Innere Medizin, Universitätsspital Zürich.
authors.forename: D
authors.initials: D
authors.lastname: Binder
authors.forename: R
authors.initials: R
authors.lastname: Jost
authors.forename: R
authors.initials: R
authors.lastname: Flury
authors.forename: F
authors.initials: F
authors.lastname: Salomon
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation; D001463:Barbiturates / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D008111:Liver Function Tests; D010634:Phenobarbital / Q000009:adverse effects* / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
chemical_list: D001463:Barbiturates; D004338:Drug Combinations; D011619:Psychotropic Drugs; C006648:difebarbamate, febarbamate, phenobarbital drug combination; D010634:Phenobarbital
vernacular_title: Akutes Leberversagen nach Tetrabamat.