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ARTICLE |

Treatment of Phenobarbital Overdose With Activated Charcoal FREE

Mark J. Goldberg, MD; William G. Berlinger, MD
[+] Author Affiliations

Reprint requests to Department of Medicine, University of Iowa Hospital, Iowa City, IA 52242 (Dr Goldberg).


JAMA. 1982;247(17):2400-2401. doi:10.1001/jama.1982.03320420050032
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Patients with phenobarbital overdose who are treated only with supportive care may remain comatose for several days because of the long elimination half-life of phenobarbital. We treated two patients with phenobarbital overdoses with the nasogastric administration of multiple doses of activated charcoal. This safe therapy markedly shortened both the elimination half-life of phenobarbital and the duration of coma in these patients. If all such patients respond similarly, we believe that the nasogastric administration of multiple doses of activated charcoal is the method of choice to accelerate the elimination of phenobarbital from the body.

(JAMA 1982;247:2400-2401)

REFERENCES

Clemmesen C, Nilsson E:  Therapeutic trends in the treatment of barbiturate poisoning: The Scandinavian method . Clin Pharmacol Ther 1961;;2:220-229.
Henderson LW, Merrill JP:  Treatment of barbiturate intoxication . Ann Intern Med 1966;; 64:876-890.
Neuvonen PJ, Elonen E:  Effect of activated charcoal on absorption and elimination of phenobarbitone, carbamazepine and phenylbutazone in man . Eur J Clin Pharmacol 1980;;17:51-57.
Sunshine I, Hackett ER:  Barbiturate studies: II. Correlation between clinical condition and blood barbiturate levels . Am J Clin Pathol 1954;;24:1133-1138.
Setter JG, Maher JF, Schreiner GE:  Barbiturate intoxication: Evaluation of therapy including dialysis in a large series selectively referred because of severity . Arch Intern Med 1966;;117:224-236.
Yatzidis H:  The use of ion exchange resins and charcoal in acute barbiturate poisoning , in Matthew H (ed): Acute Barbiturate Poisoning . Amsterdam, Excerpta Medica, 1971;, pp 223-232.
Myschetzky A, Lassen NA:  Forced diuresis in treatment of acute barbiturate poisoning , in Matthew H (ed): Acute Barbiturate Poisoning . Amsterdam, Excerpta Medica, 1971;, pp 195-204.
Costello JB, Poklis A:  Treatment of massive phenobarbital overdose with dopamine diuresis . Arch Intern Med 1981;;141:938-940.
Monselli PL, Rizzo M, Garattini S:  Interaction between phenobarbital and diphenylhydantoin in animals and in epileptic patients . Ann NY Acad Sci 1971;;179:88-107.
Viswanathan CT, Booker HE, Welling PG:  Pharmacokinetics of phenobarbital following single and repeated doses . J Clin Pharmacol 1979;;19:282-289.

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Clemmesen C, Nilsson E:  Therapeutic trends in the treatment of barbiturate poisoning: The Scandinavian method . Clin Pharmacol Ther 1961;;2:220-229.
Henderson LW, Merrill JP:  Treatment of barbiturate intoxication . Ann Intern Med 1966;; 64:876-890.
Neuvonen PJ, Elonen E:  Effect of activated charcoal on absorption and elimination of phenobarbitone, carbamazepine and phenylbutazone in man . Eur J Clin Pharmacol 1980;;17:51-57.
Sunshine I, Hackett ER:  Barbiturate studies: II. Correlation between clinical condition and blood barbiturate levels . Am J Clin Pathol 1954;;24:1133-1138.
Setter JG, Maher JF, Schreiner GE:  Barbiturate intoxication: Evaluation of therapy including dialysis in a large series selectively referred because of severity . Arch Intern Med 1966;;117:224-236.
Yatzidis H:  The use of ion exchange resins and charcoal in acute barbiturate poisoning , in Matthew H (ed): Acute Barbiturate Poisoning . Amsterdam, Excerpta Medica, 1971;, pp 223-232.
Myschetzky A, Lassen NA:  Forced diuresis in treatment of acute barbiturate poisoning , in Matthew H (ed): Acute Barbiturate Poisoning . Amsterdam, Excerpta Medica, 1971;, pp 195-204.
Costello JB, Poklis A:  Treatment of massive phenobarbital overdose with dopamine diuresis . Arch Intern Med 1981;;141:938-940.
Monselli PL, Rizzo M, Garattini S:  Interaction between phenobarbital and diphenylhydantoin in animals and in epileptic patients . Ann NY Acad Sci 1971;;179:88-107.
Viswanathan CT, Booker HE, Welling PG:  Pharmacokinetics of phenobarbital following single and repeated doses . J Clin Pharmacol 1979;;19:282-289.
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