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Activated Charcoal in Phenobarbital Overdose-Reply

Susan M. Pond, MB, BS; John D. Osterloh, MD; Kent R. Olson, MD; Theodore G. Tong, PharmD
JAMA. 1985;253(8):1121. doi:10.1001/jama.1985.03350320040010.
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In Reply.—  Goldberg and colleagues have pointed out a number of reasons why our group of phenobarbital-overdosed patients treated with repeated doses of charcoal may have been more ill than the control group. They suggest this because of some differences in the numbers of patients in the single-dose and repeated-dose groups that had high phenytoin or alcohol concentrations, aspiration pneumonia, low mean arterial pressure, and high Fio2 requirement. We looked at the data from each subject to see if patients with these factors had longer coma times than the others in the group. This was not the case. Patient 9, aged 32 years, at the time of hospital admission, had a mean arterial pressure of 26 mm Hg and aspiration pneumonia, required an Fio2 of 0.4, a blood alcohol concentration of 87 mg/dL and a serum phenytoin concentration of 25 μg/mL However, it was only 44 hours after


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