Please use this identifier to cite or link to this item:
https://ahro.austin.org.au/austinjspui/handle/1/17944
Full metadata record
DC Field | Value | Language |
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dc.contributor.author | Chiew, Angela L | - |
dc.contributor.author | Wright, Daniel F B | - |
dc.contributor.author | Dobos, Nicola M | - |
dc.contributor.author | McArdle, Kylie | - |
dc.contributor.author | Mostafa, Ahmed A | - |
dc.contributor.author | Newth, Annemarie | - |
dc.contributor.author | Roberts, Michael S | - |
dc.contributor.author | Isbister, Geoffrey K | - |
dc.date | 2018-03-13 | - |
dc.date.accessioned | 2018-06-21T05:42:58Z | - |
dc.date.available | 2018-06-21T05:42:58Z | - |
dc.date.issued | 2018-12 | - |
dc.identifier.citation | British journal of clinical pharmacology 2018; 84(12): 2923-2927 | - |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/17944 | - |
dc.description.abstract | Massive metformin overdose can cause metabolic acidosis with hyperlactatemia. A 55-year-old woman presented 5 h after multidrug overdose, including 132 g extended-release metformin. Continuous venovenous haemodiafiltration (CVVHDF) and noradrenaline were commenced due to metabolic acidosis (pH 7.0, lactate 17 mmol l-1 ) and shock. Despite 3 h of CVVHDF, her acidosis worsened (pH 6.83, lactate 24 mmol l-1 ). Intermittent haemodialysis (IHD) improved acidosis (pH 7.13, lactate 26 mmol l-1 ) but again worsened (pH 6.91, lactate 30 mmol l-1 ) with CVVHDF recommencement. IHD (12 h), CVVHDF (26 h) and vasopressor support for 7 days resulted in survival. Measured metformin concentrations were extremely high with a peak of 292 μg ml-1 at 8 h postingestion. IHD, but not CVVHDF in this case, was associated with improvement in metabolic acidosis and hyperlactataemia. Pharmacokinetic analysis of metformin concentrations found a reduced apparent oral clearance of 8.2 l h-1 and a half-life of approximately 30 h. During IHD, the apparent oral clearance increased to 22.2 l h-1 with an approximate half-life of 10 h. The impact of prolonged oral absorption from a pharmacobezoar and redistribution of metformin from peripheral sites (including erythrocytes) on the pharmacokinetic profile cannot be determined from the data available. | - |
dc.language.iso | eng | - |
dc.subject | extracorporeal elimination | - |
dc.subject | metabolic acidosis | - |
dc.subject | metformin | - |
dc.subject | overdose | - |
dc.title | 'Massive' metformin overdose. | - |
dc.type | Journal Article | - |
dc.identifier.journaltitle | British journal of clinical pharmacology | - |
dc.identifier.affiliation | New South Wales Poisons Information Centre, Children's Hospital at Westmead, Westmead, New South Wales, Australia | - |
dc.identifier.affiliation | School of Pharmacy, University of Otago, Dunedin, New Zealand | - |
dc.identifier.affiliation | Intensive Care Unit, Western Health, Melbourne, Victoria, Australia | - |
dc.identifier.affiliation | School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia | - |
dc.identifier.affiliation | Victorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australia | - |
dc.identifier.affiliation | Pharmaceutical Chemistry Department, Helwan University, Helwan, Egypt | - |
dc.identifier.affiliation | Translational Research Institute, Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia | - |
dc.identifier.affiliation | Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia | - |
dc.identifier.affiliation | Clinical Toxicology Research Group, University of Newcastle, Callaghan, New South Wales, Australia | - |
dc.identifier.doi | 10.1111/bcp.13582 | - |
dc.identifier.orcid | 0000-0002-0079-5056 | - |
dc.identifier.orcid | 0000-0001-9313-9252 | - |
dc.identifier.orcid | 0000-0003-1519-7419 | - |
dc.identifier.pubmedid | 29534338 | - |
dc.type.austin | Journal Article | - |
item.languageiso639-1 | en | - |
item.fulltext | No Fulltext | - |
item.grantfulltext | none | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.cerifentitytype | Publications | - |
item.openairetype | Journal Article | - |
Appears in Collections: | Journal articles |
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