PMID: 16615674Apr 18, 2006Paper

Monitoring of verapamil enantiomers concentration in overdose

Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
Jolanta WilimowskaEwa Florek

Abstract

A 52-year-old woman with a history of depression and personality disorders, hypertension, coronary disease and asthma was admitted to the Department of Clinical Toxicology after taking 60 tablets of Staveran (immediate release verapamil), and 4 tablets of acetaminophen. One and a half hours after ingestion her condition was critical. She required endotracheal intubation and artificial respiration. Her heart rate was 75 beats per minute, (bpm) and her blood pressure dropped from 70/50 to 50/00 mmHg. Additionally, drowsiness and headache were observed. On admission, R-(+)- and S-(-)-verapamil serum concentrations were 2252 ng/ml and 810 ng/ ml, respectively. Monitoring of the verapamil serum concentration was carried out over 74 h. Terminal elimination half-lives were 18.7 (21.3) and 17.0 (18.5) hours, respectively, for R-(+)- and S-(-)-verapamil. Monitoring of verapamil enantiomers concentrations in serum indicated a higher concentration of the less active form and slightly faster elimination of the more active enantiomer. The data-support a stereoselective difference between first pass clearance and later systemic clearance of verapamil, when taken in overdose.

References

Jun 1, 1995·British Journal of Clinical Pharmacology·C D Buckley, J K Aronson
Sep 1, 1995·Pharmacotherapy·D R Brocks, F Jamali
Jan 1, 1997·Human & Experimental Toxicology·K T KivistöL Tarssanen
Apr 29, 1998·Japanese Circulation Journal·H OeN Ohgitani
Dec 1, 2000·Annales Françaises D'anesthèsie Et De Rèanimation·F LapostolleF Baud

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Citations

Jan 26, 2010·Expert Opinion on Drug Metabolism & Toxicology·Christian HöchtCarlos Alberto Taira
Jan 6, 2011·Basic & Clinical Pharmacology & Toxicology·Bruno MégarbaneFrédéric J Baud
Sep 1, 2006·Biopharmaceutics & Drug Disposition·Dion R Brocks
May 19, 2017·BMC Cardiovascular Disorders·Kristoffer BernhemLena Scott
Nov 30, 2018·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Afaf S OsmanMahmoud M Kamel
Aug 4, 2020·Chemistry : a European Journal·Holly E BonfieldMarc Reid

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