Gosselin B, Mathieu D, Chopin C, Wattel F, Dupuis B, Haguenoer J M, Desprez M
Clin Toxicol. 1980 Oct;17(3):439-49. doi: 10.3109/15563658008989994.
Diisopyramide overdose induces an early and severe cardiogenic shock; hemoperfusion on resin (Amberlite XAD 4) is the most efficient treatment. In vitro, 92% of the drug is adsorbed in 240 min. In dog, the plasmatic epuration is 66% with a mean plasma clearance of 74% plasmatic flow. A woman who had absorbed 4.50 g diisopyramide showed an idioventricular rhythm. The cardiac electrical stimulation and positive inotrope drugs were inefficient. Hemoperfusion on resin Amberlite XAD 4 corrected hemodynamic and ECG disturbances in 4 h. The epuration was proved by the decrease of diisopyramide plasma level: 24.4 micrograms/mL before epuration, 1.9 micrograms/mL after epuration, and a mean plasma clearance of 107.8 mL/min (61% of the plasmatic flow). Hemoperfusion of resin (Amberlite XAD 4) is more efficient than hemodialysis (cuprophan) and hemofiltration (polyacrylonitrile). The system that we have used is well tolerated and of low cost.
双异丙吡胺过量会引发早期严重的心源性休克；使用树脂（Amberlite XAD 4）进行血液灌流是最有效的治疗方法。在体外，92%的药物在240分钟内被吸附。在狗身上，血浆清除率为66%，平均血浆清除率为血浆流量的74%。一名摄入4.50克双异丙吡胺的女性出现了心室自主节律。心脏电刺激和正性肌力药物均无效。使用Amberlite XAD 4树脂进行血液灌流在4小时内纠正了血流动力学和心电图紊乱。双异丙吡胺血浆水平的下降证明了清除效果：灌流前为24.4微克/毫升，灌流后为1.9微克/毫升，平均血浆清除率为107.8毫升/分钟（占血浆流量的61%）。树脂（Amberlite XAD 4）血液灌流比血液透析（铜仿膜）和血液滤过（聚丙烯腈）更有效。我们所使用的系统耐受性良好且成本低廉。
