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Plasmapheresis is useful in phenprobamate overdose
Mucahit Emet1, Sahin Aslan, Zeynep Gokcan Cakir
1Department of Emergency Medicine, Ataturk University, Erzurum 25200, Turkey. mucahitemet@gmail.com
The American Journal of Emergency Medicine
|June 6, 2009
Summary
Skeletal muscle relaxant overdose can be fatal, despite previous claims. Plasmapheresis effectively treated a phenprobamate overdose patient when hemoperfusion was unavailable, resolving severe neurological and psychiatric symptoms.
Area of Science:
- Toxicology
- Pharmacology
- Neurology
Background:
- Skeletal muscle relaxant ingestion is increasingly recognized as a significant cause of mortality.
- Previous literature suggested low morbidity and mortality rates, but recent data indicates it's a leading cause of death in toxic exposures.
Observation:
- A case of phenprobamate overdose presented with dominant neurologic and psychiatric symptoms.
- Hemoperfusion was not feasible due to equipment limitations.
- Hemodialysis yielded an inadequate clinical response.
Findings:
- Plasmapheresis, utilizing 12 units of fresh frozen plasma over two days, successfully resolved the patient's neurologic and psychiatric symptoms.
- The patient was discharged on the fifth day with no residual complications.
Implications:
- Plasmapheresis emerges as a potentially superior treatment modality for phenprobamate intoxication when hemoperfusion is not possible.
- This case highlights the critical need for advanced extracorporeal techniques in managing severe skeletal muscle relaxant overdoses.
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