Vasavada Nina, Williams Craig, Hellman Richard N
Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pharmacotherapy. 2003 Dec;23(12):1652-8. doi: 10.1592/phco.23.15.1652.31968.
A 42-year-old man was brought to the emergency department with ethylene glycol intoxication. He was hemodynamically stable and had normal renal function. His serum ethylene glycol concentration was 284 mg/dl approximately 1 hour after ethylene glycol consumption. The patient was treated with fomepizole and forced diuresis. Elimination of ethylene glycol in this patient followed first-order pharmacokinetics. Elimination pharmacokinetics in this patient were compared with that in a patient who received fomepizole and hemodialysis. Fomepizole monotherapy can be given in patients without renal failure or metabolic acidosis even with serum ethylene glycol concentrations greater than 50 mg/dl. However, cost estimates based on this case suggest that if the patient is treated adequately with a single hemodialysis session and 24-hour hospitalization, then fomepizole monotherapy may be more expensive than the combination regimen of fomepizole and hemodialysis.
一名42岁男性因乙二醇中毒被送往急诊科。他血流动力学稳定，肾功能正常。饮用乙二醇约1小时后，其血清乙二醇浓度为284mg/dl。患者接受了甲吡唑治疗和强制利尿。该患者体内乙二醇的消除符合一级药代动力学。将该患者的消除药代动力学与接受甲吡唑和血液透析的患者进行了比较。即使血清乙二醇浓度大于50mg/dl，对于无肾衰竭或代谢性酸中毒的患者也可给予甲吡唑单一疗法。然而，基于该病例的成本估算表明，如果患者通过单次血液透析治疗和24小时住院得到充分治疗，那么甲吡唑单一疗法可能比甲吡唑与血液透析联合治疗方案更昂贵。
