在阿马托克辛中毒中中断肠肝循环的作用
Jurriaan Varekamp1, Jia Lin Tan1, Janine Stam1,2
1Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Clinical toxicology (Philadelphia, Pa.)
|February 27, 2024
概括
活性炭通过中断肠肝循环来改善阿马托克辛中毒的生存率. 这种安全而廉价的治疗方法还可以降低肝功能标志物,而不会影响肝损伤标志物.
科学领域:
- 毒理学 毒理学 毒理学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 毒素中毒需要有效的治疗策略.
- 肠肝循环的中断是治疗的一个建议机制.
- 这种方法的有效性,特别是活性炭,需要进行系统的评估.
研究的目的:
- 系统地审查肠肝循环中断在阿马托克辛中毒中的作用.
- 评估活性炭对患者结果和实验室值的影响.
主要方法:
- 对133篇出版物 (1,119个案例) 的系统审查.
- 从病例报告和系列中提取的数据.
- 评估患者的特征,结果和实验室值.
主要成果:
- 活性炭 (n=667) 与对照组 (n=452,75%) 相比,显示出更高的生存率 (83%).
- 活性炭显著降低了峰值血清总 bilirubin 和国际正常化比率.
- 在峰肝损伤酶 (ALT,AST) 中没有发现显著差异.
结论:
- 活性炭通过肠肝循环中断增强了阿马托克辛的排泄.
- 这提供了一种安全且具有成本效益的吸收后治疗阿马托克辛中毒的方法.
- 活性炭与改善生存率和减少肝功能标志物有关.
相关概念视频
Prevention of Further Absorption of Poison
821
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
821
Hepatic Drug Excretion: Enterohepatic Cycling
1.5K
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
1.5K
Toxic Reactions: Overview
973
When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
973
Enhanced Elimination of Poison
511
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
511
Anticholinesterase Agents: Poisoning and Treatment
856
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
856
Factors Influencing Drug Absorption: Disease States and Pharmacology
515
Multiple disease states can significantly influence the oral drug absorption process by affecting blood flow and the functionality of the gastrointestinal (GI) system. Various GI diseases, including conditions that alter GI motility, such as diarrhea, decreased acid secretions (achlorhydria), and infections, have been associated with reduced drug absorption.
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
515


