0000000000165783
AUTHOR
S. Okonek
showing 13 related works from this author
Determination of acetylcholine, nitrostigmine and acetylcholinesterase activity in four patients with severe nitrostigmine (E 605 forte) intoxication.
1974
Concentrations of acetylcholine and nitrostigmine as well as acetylcholinesterase activity were determined in 4 patients with severe nitrostigmine intoxication. In the acute phase of the intoxication, acetylcholine levels up to 36 and 55 ng/ml were found in blood plasma and cerebrospinal fluid, respectively. At the same time no activity of acetylcholinesterase in plasma and erythrocytes was detected. Acetylcholinesterase activity gradually recovered at the end of the second week. In the first 3 days after the ingestion plasma nitrostigmine concentrations ranged from 409 to 86 ng/ml. At the end of the third week nitrostigmine was still found in a concentration of about 1 ng/ml plasma. Redist…
Elimination of Parathion by Hemoperfusion in Severe E 605 ForteR Intoxication in Vivo
1978
Severe parathion (P) intoxication results in complete inhibition of cholinesterase activity and toxic accumulation of acetylcholine. Besides these well known biochemical changes, there is evidence of direct toxic effects on the cardio-vascular system which may prove fatal due to an excess of P.
Probable progress in the therapy of organophosphate poisoning
1976
Whether or not extracorporeal hemodialysis or hemoperfusion with coated activated charcoal might be used in eliminating organophosphates following poisoning with nitrostigmine, demeton-S-methyl sulfoxide, or dimethoate was here examined. Nitrostigmine could not be hemodialysed. The other two organophosphates, on the other hand could be well eliminated from the blood by hemodialysis. The clearance rates for demeton-S-methyl sulfoxide and dimethoate were 52.98 ml/min and 59.07 ml/min respectively, at a blood flow rate of 100 ml/min. The clearance values for hemoperfusion with coated activated charcoal were higher under the same trial conditions, the values being 83.70 ml/min for demeton-S-met…
On the question of extracorporeal hemodialysis in diquat intoxication.
1975
Extracorporeal hemodialyses were carried out in a female patient with severe diquat intoxication. Diquat clearance was on average, 3.17 ml/min. Only 0.84 mg diquat could be eliminated from the blood serum by 11.5 hrs of dialysis. Hemodialysis is therefore not an efficient technique for removing amounts of diquat from the organism that are toxicologically relevant one day after ingestion.
H�moperfusion durch verkapselte Aktivkohle zur Therapie exogener und endogener Intoxikationen
1976
Die von Chang entwickelte Methode, artefizielle Zellen — in Kollodium und Albumin verkapselte Aktivkohle — zur Hamoperfusion einzusetzen, wurde in vitro studiert. Gepruft wurde die Kapazitat zur Adsorption von schlecht wie gut dialysablen Substanzen (Barbiturate, Diazepam, Parathion) und einem endogen toxischen Metaboliten (p-Hydroxyphenylessigsaure). — Mit der Adsorptions-Einheit lassen sich in 90 min 80–90% der Ausgangskonzentrationen von Barbiturat, Diazepam und p-Hydroxyphenylacetat eliminieren, von Parathion etwa 50%, Bromid und Ammoniak werden nicht adsorbiert. Versuche, durch den Einbau von Heparin in die Hulle der Kohlegranula die regionale Heparinisierung unnotig zu machen, waren e…
Haemoperfusion: a useful therapy for a severely poisoned patient?
1986
Although it is many years since a haemodialysis and haemoperfusion over uncoated and later coated charcoal columns have been used for the treatment of intoxicated patients, the clinical efficacy of these extracorporeal techniques in the treatment of severely poisoned patients remains a matter of debate. Some of the reasons for this controversy may be the indiscriminate use of haemoperfusion in any form of intoxication, the lack of well-controlled studies and the wrong interpretation of the high haemoperfusion clearance values sometimes obtained. Simple pharmacokinetic principles are applied to this type of treatment and some practical guidelines as to how and when haemoperfusion should be …
Therapeutic properties of haemodialysis and blood exchange transfusion in organophosphate poisoning
1976
Human blood was contaminated with nitrostigmine, dimethoate and demeton-S-methyl sulfoxide. It was then dialysed, concentrations of organophosphates were determined and dialysance values calculated. The influence of blood exchange transfusion on poison elimination as well as on the cholinesterase activity of blood, brain and muscle was studied in rats poisoned with nitrostigmine. Haemodialysis was found to be quite an effective method for eliminating demeton-S-methyl sulfoxide and dimethoate, dialysance values of 52.98 ml/min and 59.07 ml/min being found for demeton-S-methyl sulfoxide and dimethoate respectively. Nitrostigmine could not be removed by haemodialysis. These findings suggest th…
Digoxin and digitoxin elimination in man by charcoal hemoperfusion
1978
Since there is no widely used causal means of reducing the severity of massive digitalis intoxication the capability of hemoperfusion with coated activated charcoal to remove toxicologically relevant amounts of digoxin and digitoxin was evaluated in vitro and in man. At a blood flow rate of 100 ml/min the digoxin clearance by hemoperfusion in vitro was 51±8 ml/min in comparison to 24.3±11.3 ml/min by hemodialysis. The average hemoperfusion clearance of digitoxin was 31.7±13.4 ml/min, whereas almost no digitoxin was removed by hemodialysis. These clearance values point to the ability of hemoperfusion of eliminating digitalis glycosides from the blood. They do not clarify the essential questi…
Efficacy of gut lavage, hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication
1976
Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents. Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1-2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be e…
An economical hemoperfusion system to determine in vitro clearances of various poisons with different adsorbents.
1980
An economical hemoperfusion system for clearance studies in vitro was developped. It was ascertained, that hemoperfusion using columns which contain 13 g of adsorbent and perfused at a blood flow rate of 1.25 ml/min results in the same relative clearances as when using clinical sized columns containing 300–355 g of the absorbent and run at 100 ml/min. The adsorption kinetics of toxicologically important drugs and pesticides are given as examples. To date 27 substances were tested systematically. The investigation has shown, that no adsorbent is without exception the best one, but the efficacy can vary from substance to substance.
Near fatal percutaneous paraquat poisoning
1983
A fatal paraquat poisoning can occur when relatively large areas of skin are contaminated with a concentrated solution of paraquat (Gramoxone). A paraquat absorption takes place of the same magnitude as that with an equal dose per os. In the presence of mechanical or chemical lesion of the skin the percutaneous paraquat absorption is distinctly enhanced.
Unerwartete metabolische Azidose bei schwerer Lauge-Intoxikation
1981
Bei einer 38jahrigen Patientin mit einer schweren peroralen Lauge-Intoxikation ohne Schock entwickelte sich trotz Substitutions-Therapie eine uber 8 Tage andauernde metabolische Azidose. Die metabolische Azidose wurde durch eine Akkummulation von Milchsaure verursacht. Die gesteigerte Laktatproduktion in den Randbezirken veratzter Areale des Verdauungstrakts sowie ein gestorter hepatischer Laktatabbau sind mit groser Wahrscheinlichkeit fur die Laktazidose bei Lauge-Intoxikation verantwortlich.
Successful treatment of paraquat poisoning: activated charcoal per os and "continuous hemoperfusion".
1982
AbstractIngestion of paraquat results in an extremely dangerous poisoning. The first aim is to clear the gastrointestinal tract by inducing emesis and performing gastric/gut lavage; as much activated charcoal as possible should be administered per os and as quickly as possible. The best measure to eliminate paraquat from blood and tissue is hemoperfusion with coated activated charcoal; it has to be performed in the sense of “continuous hemoperfusion” about 8 h/d over a period of 2–3 weeks. These measures give a chance to lower the lethality of paraquat poisoning.