Toxicokinetics of nortriptyline and amitriptyline : two case reports
Two cases are presented of intentional intoxications with the tricyclic antidepressants (TCAs) nortriptyline (NT) and amitriptyline (AT). The peak plasma concentrations were 2290 microg/L and 2900 microg/L, respectively. The active metabolites E-10-hydroxynortriptyline (EHNT) and Z-10-hydroxynortriptyline (ZHNT) profiles were quite different as monitored for 5 to 10 days after presumed drug intake. In conclusion, these cases illustrate that (1) metabolite formation and elimination after intake of an overdose dose of NT and AT are stereoselective, and (2) NT and EHNT toxicokinetics and toxicodynamics are quite different. It also shows that a patient with a severe TCA overdose can still survive if he or she receives appropriate and quick supportive care, even if the prognostic markers QRS time, coma grade, and serum TCA levels predict poor outcome.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2003 |
|---|---|
| Erschienen: |
2003 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
|---|---|
| Enthalten in: |
Therapeutic drug monitoring - 25(2003), 2 vom: 24. Apr., Seite 248-51 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Franssen, E J F [VerfasserIn] |
|---|
| Themen: |
1806D8D52K |
|---|
| Anmerkungen: |
Date Completed 05.08.2003 Date Revised 06.09.2019 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM124312365 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM124312365 | ||
| 003 | DE-627 | ||
| 005 | 20231222203252.0 | ||
| 007 | tu | ||
| 008 | 231222s2003 xx ||||| 00| ||eng c | ||
| 028 | 5 | 2 | |a pubmed24n0415.xml |
| 035 | |a (DE-627)NLM124312365 | ||
| 035 | |a (NLM)12657923 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Franssen, E J F |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Toxicokinetics of nortriptyline and amitriptyline |b two case reports |
| 264 | 1 | |c 2003 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 05.08.2003 | ||
| 500 | |a Date Revised 06.09.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Two cases are presented of intentional intoxications with the tricyclic antidepressants (TCAs) nortriptyline (NT) and amitriptyline (AT). The peak plasma concentrations were 2290 microg/L and 2900 microg/L, respectively. The active metabolites E-10-hydroxynortriptyline (EHNT) and Z-10-hydroxynortriptyline (ZHNT) profiles were quite different as monitored for 5 to 10 days after presumed drug intake. In conclusion, these cases illustrate that (1) metabolite formation and elimination after intake of an overdose dose of NT and AT are stereoselective, and (2) NT and EHNT toxicokinetics and toxicodynamics are quite different. It also shows that a patient with a severe TCA overdose can still survive if he or she receives appropriate and quick supportive care, even if the prognostic markers QRS time, coma grade, and serum TCA levels predict poor outcome | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Antidepressive Agents, Tricyclic |2 NLM | |
| 650 | 7 | |a Amitriptyline |2 NLM | |
| 650 | 7 | |a 1806D8D52K |2 NLM | |
| 650 | 7 | |a Nortriptyline |2 NLM | |
| 650 | 7 | |a BL03SY4LXB |2 NLM | |
| 700 | 1 | |a Kunst, P W A |e verfasserin |4 aut | |
| 700 | 1 | |a Bet, P M |e verfasserin |4 aut | |
| 700 | 1 | |a Strack van Schijndel, R J M |e verfasserin |4 aut | |
| 700 | 1 | |a van Loenen, A C |e verfasserin |4 aut | |
| 700 | 1 | |a Wilhelm, A J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Therapeutic drug monitoring |d 1993 |g 25(2003), 2 vom: 24. Apr., Seite 248-51 |w (DE-627)NLM000962295 |x 1536-3694 |7 nnns |
| 773 | 1 | 8 | |g volume:25 |g year:2003 |g number:2 |g day:24 |g month:04 |g pages:248-51 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 25 |j 2003 |e 2 |b 24 |c 04 |h 248-51 | ||