Veerman M, Espejo M G, Christopher M A, Knight M
Department of Pharmacy, Shands Hospital, Gainesville, Florida.
J Toxicol Clin Toxicol. 1991;29(1):53-8. doi: 10.3109/15563659109038597.
The course of a neonate administered activated charcoal orally for elevated phenobarbital concentration is described. The neonate required a serum concentration of phenobarbital eventually exceeding 80 micrograms/mL for seizure control. However, due to the severe CNS injury as a result of the asphyxia at birth, a diagnosis of cerebral death by electroencephalogram and apnea test was pursued. This required the phenobarbital concentration to be less than 30 micrograms/mL. Serial phenobarbital concentrations during this time indicated a 250 hour half-life, which would require two weeks for the phenobarbital to drop below 30 micrograms/mL. With the administration of six doses of activated charcoal at 0.7 g/kg/dose, the phenobarbital serum concentration decreased to 22 micrograms/mL, giving an estimated phenobarbital half-life of 22 hours. This, and two other subsequent cases, indicates repeated doses of activated charcoal are effective in augmenting the clearance of certain drugs in the neonatal age group.
本文描述了一名因苯巴比妥浓度升高而口服活性炭的新生儿的病程。该新生儿为控制癫痫发作，最终需要苯巴比妥血清浓度超过80微克/毫升。然而，由于出生时窒息导致严重的中枢神经系统损伤，遂通过脑电图和呼吸暂停试验进行脑死亡诊断。这要求苯巴比妥浓度低于30微克/毫升。在此期间，连续的苯巴比妥浓度显示其半衰期为250小时，这意味着苯巴比妥浓度降至30微克/毫升以下需要两周时间。给予六剂0.7克/千克剂量的活性炭后，苯巴比妥血清浓度降至22微克/毫升，估计苯巴比妥半衰期为22小时。这例以及另外两例后续病例表明，重复给予活性炭可有效提高新生儿年龄组某些药物的清除率。
