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Br J Clin Pharmacol. 2011 Jul;72(1):125-32. doi: 10.1111/j.1365-2125.2011.03934.x.

The effect of decontamination procedures on the pharmacodynamics of venlafaxine in overdose.

Author information

  • 1School of Pharmacy, University of Otago, Dunedin, New Zealand. pavan.kumar@otago.ac.nz

Abstract

AIMS:

To investigate the relationship between decontamination procedures and seizure events caused by venlafaxine overdose and to estimate the time at which 90% of patients would have had their first seizure in the presence and absence of decontamination.

METHODS:

Data were collected from 319 patients who took an overdose of venlafaxine on 436 occasions. Seizures occurred on 24 of 436 occasions (5%). Patients received one of single dose activated charcoal (SDAC), whole bowel irrigation (WBI), a combination of either (SDAC/WBI) or no decontamination. Logistic regression and time to event analysis were used to investigate the influence of dose and decontamination on the probability of seizures and time to 90% (t(90) ) of seizure, respectively.

RESULTS:

A linear logistic regression model described the data. Simulation from the model showed that the probability of seizure was 0.05 (0.03-0.08), 0.19 (0.09-0.35) and 0.75 (0.30-0.96) at 1000, 5000 and 10 000 mg, respectively (median and 95% credible interval). At the mean dose of 2100 mg the odds ratios (OR) in the presence of SDAC, WBI and SDAC/WBI were 0.48 (0.25-0.89), 0.71 (0.35-1.22) and 0.25 (0.08-0.62), respectively. A modified Gompertz model described the time to seizure events. Simulations from the Gompertz model showed that the t(90) values for first seizure was 26 h and was not affected by dose or decontamination procedure.

CONCLUSION:

SDAC/WBI provided greater benefits than the sum of the independent effects of SDAC and WBI. Patients should be observed for at least 24 h for seizures based on the dose and risk of seizure occurring.

© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

PMID:
21306417
[PubMed - indexed for MEDLINE]
PMCID:
PMC3141194
Free PMC Article

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