Bola vyšetrená adsorpčná účinnosť aktívneho uhlia, Amberlitu XAD-2 a XAD-4 pri hemoperf úzii amitriptylínu a nortriptylínu in vitro. Celkove bolo vykonaných 15 hemoperíúzií amitriptylínu a nortriptylínu in vitro v uzavretom systéme pri použití vyššie uvedených sorbentov. Ako perfúzny roztok sme použili 3000 mi 0,9% roztoku NaCI. Koncentrácie amitriptylínu a nortriptylínu v perfúznom roztoku boli 13,1 ±0,5 mg/l, resp. 12,1±0,6mg/l. Jednotlivé hemoperfúzie trvali 5 hodín. Pri hemoperfúzii cez aktívne uhlie v 300. minúte boli koncentrácie amrtnptylínu a nortriptylínu v perfúznom roztoku 2,09±0,21 mg/l, resp. 1,95±0,14. Hemoperfúzia cez Amberlite XAD2 a XAD-4 znížila koncentráciu amitriptylínu a nortriptylínu na nulové hodnoty už v 180. minúte. Extrakcie a klírensy amitriptylínu a nortriptylínu dosiahli maximálne hodnoty (extrakcia: 1,0; klírens: 200 ml/min) v 120. minúte pri hemoperfúzii cez Amberlite XAD-2 a XAD-4. Podľa našich výsledkov získaných zo štúdie in vitro odporúčame pri akútnej otrave tricyklickými antidepresívami (amitriptylínom a nortriptylínom) u ľudí použitie hemoperfúzie cez Amberlite XAD-4 alebo XAD-2 do 6 hodín po akútnej otrave. Okrem toho u 44-ročnej chorej, ktorá sa v samovražednom úmysle otrávila amitriptylínom, sme vykonali dve hemoperfúzie cez Amberlite XAD-4. Táto liečba viedla k uzdraveniu chorej.

The absorption efficacy of charcoal, Amberlite XAD-2 and Amberlite XAD-4, in hemoperfusion using amitriptyline and nortriptylin e in vitro was assessed. Overall, 15 amitriptyline and nortriptyline hemoperfusion procedures were carried out in vitro using a clos ed sys- tem and the above sorbents. An NaCl solution (with a volume of 3,000 ml of 0.9% of NaCl) served as the perfusate. Amitriptyline and nortriptyline levels in the perfusate were 13.1±0.5 mg/l and 12.1±0.6mg/l, respectively. Individual hemoperfusion procedures la sted 5 hours. During charcoal-based hemoperfusion, amitriptyline and nortriptyline levels in perfusate at 300 minutes were 2.09±0.21 m g/l and 1.95±0.14 mg/l, respectively. Hemoperfusion using Amberlite XAD-2 and XAD-4 decreased amitriptyline and nortriptyline level s to zero as early as 180 minutes. Amitriptyline and nortriptyline extraction and clearance rates reached their peak values (extr action: 1.0; clearance: 200 ml/min) at 120 minutes during hemoperfusion with Amberlite XAD-2 and XAD-4. Based on the results of our in vitro study, we recommend to use tricyclic antidepressants for managing acute poisoning with amitriptyline and nortriptyline in man, and hemoperfusion with Amberlite XAD-4 or XAD-2 within 6 hours of acute poisoning. In addition, we performed two hemoperfusion procedures with Amberlite XAD-4 in a 44-year-old woman ingesting amitriptyline in a suicide attempt. The patient recovered succ ess- fully.

Nefrologická klinika FN L Pasteura Košice

Hemoperfusion of amitriptyline and nortriptylin - an in vitro study

Hemoperfúzia amitriptylínu a nortriptylínu - štúdia in vitro = Hemoperfusion of amitriptyline and nortriptylin - an in vitro study /

Hemoperfusion of amitriptyline and nortriptylin - an in vitro study /

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