Which is the best in carbamazepine overdose?

Türkdoğan, Kenan Ahmet; Deniz, Ahmet Tunç; Çanakçı, Selçuk Eren

doi:10.1002/ccr3.1118

Cited by 10 publications

(3 citation statements)

References 16 publications

(23 reference statements)

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“…In one study, combined use of ILE therapy and extracorporeal treatment methods did not provide additional benefits in clinical practice (21). The patients were classified based on the administered extracorporeal therapy: plasmapheresis was administered in three patients, hemoperfusion in four patients, hemofiltration in one patient, and hemodialysis in one patient.…”

Section: Discussionmentioning

confidence: 99%

Lipid Emulsion Therapy in Lipophilic or Hydrophilic Drug Intoxication: The Last Weapon in Our Arsenal

Türkdoğan¹,

Aköz²,

Avcil³

et al. 2019

Eurasian J Emerg Med

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Aim: Previous case reports have described the administration of lipid emulsion therapy in lipophilic drug intoxication cases. In this study, we wanted to contribute to the literature that lipid emulsion therapy could also be given lipid as the last weapon in not only lipophilic drug intoxication but also all intoxication cases with worsening general condition. Materials and Methods: A total of 65 patients, who presented to the emergency room and received lipid therapy between January 1, 2014 and January 1, 2017, were included in this study. Each patient was given a 20% ClinOleic (Baxter) infusion of 1.5 mL/kg for 1-3 minutes and then 100 mL/h (0.025 mL/kg/min). Toxic drugs were divided into low or high permeability groups according to their lipid/water partition coefficients (LogP). Results: Of the 65 patients, 55.4% (n=36) were female and 44.6% (n=29) were male. These patients were grouped according to a lipid/water cutoff value of 1.72. The lipid therapy was administered in addition to antidotal therapy in two patients in the hydrophilic group and in five patients in the lipophilic group. The only variable that was significantly restored 12 hours after the lipid therapy was the respiratory rate, which was 16.0 (range, 15.5-17.3)/min in the hydrophilic group and 20.0 (range, 18.0-22.0)/min in the lipophilic group (p=0.003). Conclusion: We believe that lipid therapy can be used as a last resort in intoxication cases, especially in patients with low Glasgow coma scale scores and worsened vital signs despite antidotal and extracorporeal therapies, regardless of whether the causative agent is hydrophilic or lipophilic.

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Section: Discussionmentioning

confidence: 99%

Lipid Emulsion Therapy in Lipophilic or Hydrophilic Drug Intoxication: The Last Weapon in Our Arsenal

Türkdoğan¹,

Aköz²,

Avcil³

et al. 2019

Eurasian J Emerg Med

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“…Antipsychotics Olanzapine, clozapine [195] Antidepressants Amitriptyline, nortriptyline, doxepin [196][197][198] Benzodiazepines Diazepam, midazolam [199] Sedatives Zolpidem, zopiclone [200,201] Antiepileptics Phenytoin, carbamazepine, valproic acid, gabapentin, pregabalin [202,203] Antiarrhythmic drugs Amiodarone [204] Beta-blocking agents Propranolol, metoprolol [205] Statins Simvastatin, fluvastatin, lovastatin, pitavastatin, and atorvastatin [206] Antimalarian drugs Chloroquine, mefloquine [207,208] Antifungal drugs Ketoconazole, itraconazole [209,210] Immunosuppressants Tacrolimus [211] Antivirals Ritonavir, saquinavir [212,213] Opioids Methadone [214] Antihistamines Cetirizine, loratadine [215,216] Antiparasitic drugs Ivermectin [217] Antituberculosis Rifampicin [218] Diuretics Spironolactone [219] 10.…”

Section: Chemical/pharmacological Class Compounds Referencementioning

confidence: 99%

Dietary Influence on Drug Efficacy: A Comprehensive Review of Ketogenic Diet–Pharmacotherapy Interactions

Marinescu,

Apetroaei,

Nedea

et al. 2024

Nutrients

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It is widely acknowledged that the ketogenic diet (KD) has positive physiological effects as well as therapeutic benefits, particularly in the treatment of chronic diseases. Maintaining nutritional ketosis is of utmost importance in the KD, as it provides numerous health advantages such as an enhanced lipid profile, heightened insulin sensitivity, decreased blood glucose levels, and the modulation of diverse neurotransmitters. Nevertheless, the integration of the KD with pharmacotherapeutic regimens necessitates careful consideration. Due to changes in their absorption, distribution, metabolism, or elimination, the KD can impact the pharmacokinetics of various medications, including anti-diabetic, anti-epileptic, and cardiovascular drugs. Furthermore, the KD, which is characterised by the intake of meals rich in fats, has the potential to impact the pharmacokinetics of specific medications with high lipophilicity, hence enhancing their absorption and bioavailability. However, the pharmacodynamic aspects of the KD, in conjunction with various pharmaceutical interventions, can provide either advantageous or detrimental synergistic outcomes. Therefore, it is important to consider the pharmacokinetic and pharmacodynamic interactions that may arise between the KD and various drugs. This assessment is essential not only for ensuring patients’ compliance with treatment but also for optimising the overall therapeutic outcome, particularly by mitigating adverse reactions. This highlights the significance and necessity of tailoring pharmacological and dietetic therapies in order to enhance the effectiveness and safety of this comprehensive approach to managing chronic diseases.

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“…it penetrates well through cell membranes and is highly lipid soluble. [26][27][28][45][46][47] The formation of the CBZ polymorphs and dihydrate is sensitive to humidity, 34,48 surfactants, 49 the presence of organic compounds with different functional groups assembled as an ordered surface layer at gold particles, 50 the crystallisation technique, 38,51 and the protocol of mechanical treatment, 48,[52][53][54][55][56][57] including adding polymers upon crystallisation from methanol-ethanol solution, 33,58 or upon grinding. 55,59 This makes carbamazepine an interesting system, when probing the possible effects of the fingerprint components on the outcome of mechanical treatment.…”

Section: Introductionmentioning

confidence: 99%

To touch or not to touch? Fingerprint-assisted grinding of carbamazepine form III

Zheltikova,

Losev,

Boldyreva

2023

CrystEngComm

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Which is the best in carbamazepine overdose?

Abstract: Key Clinical MessageIntravenous lipid emulsion treatment is safer, faster, and easier to apply and could be a powerful alternative to extracorporeal treatment methods in carbamazepine intoxication.

Cited by 10 publications

References 16 publications

Lipid Emulsion Therapy in Lipophilic or Hydrophilic Drug Intoxication: The Last Weapon in Our Arsenal

Lipid Emulsion Therapy in Lipophilic or Hydrophilic Drug Intoxication: The Last Weapon in Our Arsenal

Dietary Influence on Drug Efficacy: A Comprehensive Review of Ketogenic Diet–Pharmacotherapy Interactions

To touch or not to touch? Fingerprint-assisted grinding of carbamazepine form III

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