Treatment of baclofen overdose by haemodialysis: a pharmacokinetic study

Wu, Vin-Cent; Lin, Shuei‐Liong; Lin, Shu-Meng; Fang, Cheng-Chung

doi:10.1093/ndt/gfh297

Cited by 69 publications

(66 citation statements)

References 9 publications

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“…According to Ghose et al, baclofen plasma half-life time is 3.5 hours in therapeutic doses, and in the case of overdose, there is a 5-fold increase of plasma half-life [9]. In patients with endstage renal disease (ESRD), the half-life of baclofen is also significantly increased, even with therapeutic doses [4,22]. Hemodialysis in such patients resulted in a good clinical outcome [4,22].…”

Section: Discussionmentioning

confidence: 99%

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Correlation between the single, high dose of ingested baclofen and clinical symptoms

Anand

Zając

Waldman

et al. 2017

Ann Agric Environ Med.

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Introduction and Objectives. Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to lifethreatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. Materials and method. 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms. Results. The study found statistically significant correlations between dosage of ingested baclofen and presence of acute respiratory failure, as well as duration of mechanical ventilation. No statistically significant correlations were found between the dose of ingested baclofen and presence of hypertension, bradycardia, acute psychotic symptoms, or level of consciousness disturbance. However, it was found that patients who suffered from hypertension, bradycardia, and altered mental status ingested a larger dose of baclofen. Conclusions. There is a statistically significant correlation between the dose of ingested baclofen and the presence of acute respiratory failure, and duration of mechanical ventilation. Patients who have taken a single dose of baclofen of 200 mg, or higher, should be managed in centres able to provide continuous monitoring of life functions. Those with a higher level of a single dose of baclofen ingestion (>500 mg), should be hospitalized in a Toxicology Unit or Intensive Care Unit able to provide airway support and mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

“…The drug is rapidly absorbed from the gastrointestinal tract, reaching peak plasma concentrations after 2 hours. 30% of the drug is bound to plasma proteins and is partially metabolized in the liver (10-15%) and then removed by the kidneys [2,3,4].…”

Section: Introductionmentioning

confidence: 99%

Correlation between the single, high dose of ingested baclofen and clinical symptoms

Anand

Zając

Waldman

et al. 2017

Ann Agric Environ Med.

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“…The patient was treated with hemodialysis and showed dramatic clinical improvement. Wu et al measured the changes of baclofen serum concentration during haemodialysis and found that the serum baclofen eliminated up to 79% during the 4 hours of the haemodialysis session [7]. The elimination half-life of baclofen before and during hemodialyses was 15,7 and 3,1 hours.…”

Section: Discussionmentioning

confidence: 99%

Baclofen Intoxication in a Patient with Chronic Renal Failure

2016

J Ann Eu Med

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ÖzetBaklofen γ-aminobütirik asit (GABA) türevi olup, spastisite tedavisinde kullanıl-maktadır. Baklofen toksititesi kas gevşemesi, ciddi solunum depresyonu, nöbet, koma, bradikardi/taşikardi ya da hipotansiyon/hipertansiyona neden olabilir. Kronik böbrek yetmezliği olan 60 yaşındaki hastanın düşük doza rağmen baklofen intoksikasyonuna bağlı stupor ile başvurusunu sunduk. Anahtar KelimelerBaklofen İntoksikasyonu, Kronik Böbrek Yetmezliği, Bilinç Bulanıklığı AbstractBaclofen is a derivative of γ-aminobutyric acid (GABA), is used in the treatment of spasticity. Baclofen toxicity can cause muscle flaccidity, severe respiratory depression, seizure, coma, bradycardia/tachcardia, or hypotension/hypertension. We report on a 60-year-old female patient with chronic renal failure who presented with stupor due to baclofen intoxication in spite of low dosage.

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“…Son dönem böbrek yetersizliği olan hastalarda baklofen birikimi olduğu ve yarılanma ömrünün uzadığı belirtilmektedir (19). Yapılan birçok çalışmada renal yetersizliği olan ciddi baklofen toksisite olgularında hemodiyaliz uygulamaları ile serum baklofen kosantrasyonun hızla düştüğü, baklofen yarılanma ömrünün kısaldığı ve klinik semptomların hızla iyileştiği gösterilmiştir (20)(21)(22)(23)(24). Kısıtlı sayıda çalışmada ise normal renal fonksiyonu olan baklofen entoksikasyonu olgularında da hemodiyaliz ile yine aynı faydaların sağlandığı belirtilmektedir (25,26).…”

Section: Discussionunclassified