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Biomedical subjects

S Okonek

Publications and source records attributed to S Okonek.

At least 37 records · Page 2Linked to original sources
PubMed1978

Digoxin and digitoxin elimination in man by charcoal hemoperfusion.

Since there is no widely used causal means of reducing the severity of massive digitalis intoxication the capability of hemoperfusion with coated activated charcoal to remove toxicologically relevant amounts of digoxin and digitoxin was evaluated in vitro and in man. At a blood flow rate of 100 ml/min the digoxin clearance by hemoperfusion in vitro was 51 +/- 8 ml/min in comparison to 24.3 +/- 11.3 ml/min by hemodialysis. The average hemoperfusion clearance of digitoxin was 31.7 +/- 13.4 ml/min, whereas almost no digitoxin was removed by hemodialysis. These clearance values point to the ability of hemoperfusion of eliminating digitalis glycosides from the blood. They do not clarify the essential question whether it is possible to lower the toxic concentrations in the tissues.

Charcoal↗
PubMed1977

[Hemoperfusion with coated activated charcoal for treating acute poisoning by remedies, plant protectants, and fungi. III. Fungi (author's transl)].

Four patients with foudroyant liver dystrophy due to ingestion of fungi of the Amanita phalloides species were treated by hemoperfusion with coated activated charcoal. Three patients survived the poisoning. One patient died in a coma due to hepatic disintegration with cardiac and respiratory insufficiency. One female patient suffering from hemolytic syndrome and acute anuresis due to ingestion of fungi of the Paxillus involutus species recovered completely after treatment of combinated hemodialysis and hemoperfusion. The first hemoperfusion in the patients with Amanita phalloides poisoning were performed two to three days after ingestion of the fungus. At that time there were only traces of amanitines in the blood of one of the surviving patients. These Amanita phalloides toxins were only detected in the first 24-hour urine in the other 3 patients. It is thus not to be expected that toxicologically relevant quanities of the toxins will be eliminated from the blood by hemoperfusion carried out two to three days following ingestion of the fungus, Amanita phalloides. No coherence of restitutio ad integrum and hemoperfusion could be pointed out in the female patients suffering from hemolytic syndrom and anuresis due to Paxillus involutus.

Adult↗
PubMed1977

[Hemoperfusion with coated activated charcoal for treating acute poisoning by remedies, plant protectants, and fungi (author's transl)].

From the clinico-toxicological standpoint, the most important plant protectants are the insecticides (bipyridylium compounds). In vitro trials and investigations on poisoned patients have shown that it is fundamentally possible to eliminate such plant protectants from the blood by hemoperfusion with coated activated charcoal. With both the lipophilic alkyl phosphate, nitrostigmine (E605 forte), and by the two hydrophilic alkyl phosphates, demetone-S-methyl sulfoxide (Metasystox R) and dimethoate (Roxion), it was possible to measure hemoperfusion clearance values around 60 to 85 ml/min at a blood flow rate of 100 ml/min. Only the two hydrophilic alkyl phosphates were able to be eliminated by hemodialysis, the clearance values being, however, lower. Thus in severe alkyl phosphate intoxications the use of hemoperfusion may considered alongside the standard therapy. The bipyridylium compounds, paraquat (Gramoxone) and diquat (Reglone), are readily dialysed, but can be better eliminated from the blood by hemoperfusion. This therapeutic measure must be initiated as rapidly as possible independent of the clinical picture, for only when hemoperfusion is begun prior to the fixation of paraquat or diquat at tissue are there any prospects of success.

2,2'-Dipyridyl↗
PubMed1976

Efficacy of gut lavage, hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication.

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents. Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1-2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1-2 ppm, the clearance values for hemoperfusion were some 5-7 times higher than those for hemodialysis. In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquats less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

Adult↗
PubMed1976

[Hemoperfusion with coated activated charcoal for treating acute poisoning by remedies, plant protectants, and fungi. I. Remedies (author's transl)].

Hemoperfusion with coated activated charcoal is a novel procedure for treating acute poisoning. It enables the elimination of both, water-soluble and liposoluble toxins. Hemoperfusion with coated activated charcoal has proved to be superior to hemodialysis in the treatment of barbiturate or bromocarbamide poisoning both under experimental conditions as well as in the ward. Analogous statements may be made for the therapy of glutethimide poisoning. Methaqualone, on the other hand, could not be eliminated sufficiently well in animal trials. Intoxications by "mild" analgetics, such as paracetamol and acetylsalicylic acid, may be treated successfully with hemoperfusion. Treatment of acetylsalicylic acid poisoning is equally effective with hemoperfusion as with hemodialysis. Prospects for the success of hemoperfusion in treating intoxication from tricyclic antidepressants and neuroliptics are slight. It is simply the danger of antidepressant poisoning that justifies using this method of treatment in the first few hours after ingestion in order to reduced the flow of the psychopharmaceutical substance into the tissue.

Acetaminophen↗
PubMed1976

Probable progress in the therapy of organophosphate poisoning: extracorporeal hemodialysis and hemoperfusion.

Whether or not extracorporeal hemodialysis or hemoperfusion with coated activated charcoal might be used in eliminating organophosphates following poisoning with nitrostigmine, demeton-S-methyl sulfoxide, or dimethoate was here examined. Nitrostigmine could not be hemodialysed. The other two organophosphates, on the other hand could be well eliminated from the blood by hemodialysis. The clearance rates for demeton-S-methyl sulfoxide and dimethoate were 52.98 ml/min and 59.07 ml/min respectively, at a blood flow rate of 100 ml/min. The clearance values for hemoperfusion with coated activated charcoal were higher under the same trial conditions, the values being 83.70 ml/min for demeton-S-methyl sulfoxide and 87.84 ml/min for dimethoate. Nitrostigmine, too, could be eliminated from the blood by hemoperfusion, its clearance being 59.20 ml/min.

Adult↗
PubMed1976

[Hemoperfusion by means of encapsuled charcoal for the treatment of exogenous and endogenous intoxications].

The method developed by Chang for using in collodion and albumin encapsuled charcoal as artificial cells for hemoperfusion has been studied in vitro. The capacity for the absorption of more or less dialysable exogenous substances (barbiturate, Diazepam, Parathion) and an endogenous toxic metabolite (p-hydroxyphenyl acetic acid) has been examined. With the absorption unit one can eliminate 80 to 90 per cent of the initial concentration of barbiturate, Diazepam and p-hydroxyphenyl acetic acid in about 90 min, of Parathion about 50 per cent in the same time, whereas bromide and ammonia are not absorbed. Attempts to avoid regional heparinisation by the incorporation of heparin into the capsule of charcoal granules were not successful. Assuming correct preparation of the hemoperfusion system, observance of steril precoutions and regional heparinisation, the use of the "detoxication shunt" is a promising means in the treatment of severe exogenous and endogenous intoxications which are not accessible by conventional therapeutic means.

Adsorption↗
PubMed1976

Therapeutic properties.of haemodialysis and blood exchange transfusion in organophosphate poisoning.

Human blood was contaminated with nitrostigmine, dimethoate and demeton-S-methyl sulfoxide. It was then dialysed, concentrations of organophosphates were determined and dialysance values calculated. The influence of blood exchange transfusion on poison elimination as well as on the cholinesterase activity of blood, brain and muscle was studied in rats poisoned with nitrostigmine. Haemodialysis was found to be quite an effective method for eliminating demeton-S-methyl sulfoxide and dimethoate, dialysance values of 52.98 ml/min and 59.07 ml/min being found for demeton-S-methyl sulfoxide and dimethoate respectively. Nitrostigmine could not be removed by haemodialysis. These findings suggest that haemodialysis could be of therapeutic value in the treatment of severe demeton-S-methyl sulfoxide and dimethoate poisoning in man. By blood exchange transfusion only 0.06% of the injected dose of nitrostigmine could be removed from the body of poisoned rats. Acetylcholinesterase activity increased only briefly in the period of blood exchange transfusion and decreased gradually afterwards. The enzymatic activity of brain and muscle was unaffected. Therefore, blood exchange transfusion has, if any at all, only poor therapeutic properties in nitrostigmine intoxication.

Acetylcholinesterase↗