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Semin Dial. 2016 Sep;29(5):403-9. doi: 10.1111/sdi.12520. Epub 2016 Aug 4.

Why are we Still Dialyzing Overdoses to Tricyclic Antidepressants? A subanalysis of the NPDS database.

Author information

1
Department of Medical Biology, Sacré-Coeur Hospital, University of Montreal, Montreal, Canada.
2
Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York.
3
Indiana Poison Center, Indiana University Health, Indianapolis.
4
Department of Nephrology, Verdun Hospital, University of Montreal, Montreal, Canada.
5
Department of Medicine & Emergency Medicine, McGill University Health Centre, McGill University, Centre anti-poison du Quebec, Montreal, Canada.
6
Province of Alberta Drug Information Service, Calgary, Alberta.
7
Medical School, Australian National University and Renal Medicine, The Canberra Hospital, Canberra, Australia.
8
Department of Nephrology, Verdun Hospital, University of Montreal, Montreal, Canada. marcghannoum@gmail.com.

Abstract

A recent analysis of the American Association of Poison Control Centers database, showed that poisonings from toxins not usually considered amenable to extracorporeal purification ("non-classic toxins" such as ethanol and tricyclic antidepressants) continue to be reported. This publication investigates factors that may explain these findings. Our results suggest that: 1) the relatively high absolute number of ECTR performed for non-classic toxins may simply reflect the large number of exposures to these toxins, 2) poisoning from another toxin may have been the reason for ECTR initiation in some exposures to non-classic toxins, 3) poisoning from non-classic toxins may receive ECTR for purposes other than toxin removal, and 4) the decisional threshold to initiate ECTR may be lower for non-classic toxins because of heightened toxicity.

PMID:
27490214
DOI:
10.1111/sdi.12520
[Indexed for MEDLINE]

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