Extracorporeal Life Support and Plasmapheresis in a Case of Severe Polyintoxication

Koschny, Ronald; Lutz, Matthias; Seckinger, Joerg; Schwenger, Vedat; Stremmel, Wolfgang; Eisenbach, Christoph

doi:10.1016/j.jemermed.2014.04.044

Cited by 28 publications

(11 citation statements)

References 19 publications

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“…More than half of the case report papers ( n = 14) arose from patients presenting to a hospital or general clinic with overdose or withdrawal‐like symptoms ; two came from substance abuse clinics , three from psychiatric facilities , two from the penal system , one from postmortem toxicology findings and one from poison center reports .…”

Section: Resultsmentioning

confidence: 97%

“…Published reports came from the United States (67%, n = 22), the United Kingdom (12%, n = 4), Germany (3%, n = 1), Finland (3%, n = 1), India (3%, n = 1), South Africa (3%, n = 1), France (3%, n = 1) and two analyzed websites not specific to a particular country (6%). While all the papers in this review described gabapentin misuse/abuse, 12 (36%) were documented reports of overdose involving gabapentin .…”

Section: Resultsmentioning

confidence: 99%

“…A variety of motivations behind gabapentin misuse were identified, many that related to substance abuse behaviors in general, which included: recreational use , control of mood and/or anxiety , potentiating the effects of drug abuse treatment and intentional self‐harm . Case reports substantiated those intentions , and also identified the following: pain , reduced cravings for/managed withdrawal from other drugs , substituted for other drugs and addiction to gabapentin .…”

Section: Resultsmentioning

confidence: 99%

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Gabapentin misuse, abuse and diversion: a systematic review

2016

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Background and Aims Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind, and risk factors for gabapentin misuse, abuse, and diversion. Methods Databases were searched for peer-reviewed articles demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty-three articles met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the USA, the UK, Germany, Finland, India, South Africa, and France, and two analyzed websites not specific to a particular country. Results Prevalence of gabapentin misuse in the general population was reported to be 1%, 40–65% among individuals with prescriptions, and between 15–22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines, and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was primarily misused for recreational purposes, self-medication, or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines, and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse. Conclusions Epidemiological and case report evidence suggests that the antiepileptic and analgesic medication gabapentin is being misused internationally at a rate of about 1%, with substance abuse populations at special risk for misuse/abuse.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Gabapentin misuse, abuse and diversion: a systematic review

2016

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“…Non-pharmacologic therapies include cardiac pacing to maintain the heart rate; in addition, extracorporeal circulatory support and an aortic balloon pump could be considered for a prolonged and refractory cardiovascular compromise. 9,10 The present case suggests that the repeated use of SABA might be effective while wheezing persists. There is some evidence indicating that non-invasive positive pressure ventilation could lead to clinical improvement of acute asthma.…”

Section: Discussionmentioning

confidence: 58%

“…Activated charcoal could also be used for intoxication in general. Non‐pharmacologic therapies include cardiac pacing to maintain the heart rate; in addition, extracorporeal circulatory support and an aortic balloon pump could be considered for a prolonged and refractory cardiovascular compromise . The present case suggests that the repeated use of SABA might be effective while wheezing persists.…”

Section: Discussionmentioning

confidence: 89%

Persistent wheezing caused by carvedilol overdose in a non‐asthmatic man

Nakanishi

Kuriyama

Onodera

2019

Acute Medicine & Surgery

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Background: Cardiovascular dysfunction is the main manifestation of b-blocker intoxication; however, respiratory manifestations have rarely been reported. Case Presentation: A 41-year-old man, who had ingested 300 mg carvedilol in a suicide attempt, was transferred to our emergency department. The patient had wheezing on arrival; however, he had no known history of bronchial asthma. In the absence of signs of heart failure, we gave the patient inhaled procaterol, a short-acting b2 agonist. The wheezing disappeared approximately 60 h after carvedilol ingestion and did not recur thereafter. Conclusion: We report a case of wheezing caused by carvedilol intoxication. Although rare, clinicians should recognize that wheezing or bronchospasm can develop following b-blocker intoxication, for which a short-acting b2 agonist could be indicated.

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Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass in the Poisoned Patient

Kerns¹,

Heffner²

2017

Critical Care Toxicology

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Extracorporeal Life Support and Plasmapheresis in a Case of Severe Polyintoxication

Cited by 28 publications

References 19 publications

Gabapentin misuse, abuse and diversion: a systematic review

Gabapentin misuse, abuse and diversion: a systematic review

Persistent wheezing caused by carvedilol overdose in a non‐asthmatic man

Extracorporeal Membrane Oxygenation and Cardiopulmonary Bypass in the Poisoned Patient

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