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Biomedical subjects

G Volans

Publications and source records attributed to G Volans.

At least 19 recordsLinked to original sources
PubMed1992

Predicting severity of tricyclic antidepressant overdose.

The measurement of plasma concentration, a prolonged QRS interval, and level of consciousness have all been recommended as useful indicators of toxicity following tricyclic antidepressant overdose. The aims of this study were firstly, to determine the relative prognostic value of each of these indicators and secondly, to assess when a patient can be discharged safely from the intensive care unit. Data were evaluated on 67 patients with tricyclic antidepressant overdose from four centers. Plasma tricyclic antidepressant concentrations were measured, coma grade was evaluated using the Matthew-Lawson Coma Scale and a ECG was obtained from 23 patients on admission. Complications such as convulsions, hypotension, arrhythmias, and need for intubation and ventilation were recorded. Thirty patients developed complications and no patient died. Coma grade was the best predictor of outcome. The development of serious complications is unlikely in patients whose level of consciousness is grade II or less and who are admitted to hospital more than 6 h after overdose. Plasma tricyclic antidepressant concentration was of no additional value in predicting toxic complications or deciding when the patient could leave the intensive care unit. Our study suggests that an alert and orientated patient with a QRS duration less than 100 ms is the best indicator for safe transfer to a medical or psychiatric ward.

Adolescent↗
PubMed1988

Activated charcoal in tricyclic antidepressant poisoning.

Tricyclic antidepressants (TCA) bind to activated charcoal both in vitro and in vivo in healthy volunteers after a therapeutic dose of TCA. These findings provide a basis for the routine use of activated charcoal in TCA poisoning. The object of this study was to examine the effect of a single dose of 20 g of activated charcoal in overdose patients. Ninety-one patients from four centres with suspected TCA overdose were entered into a randomized study. Gastric lavage was performed on all patients. Thirty-four received 20 g of activated charcoal and 43 served as controls. Fourteen patients were excluded. Plasma drug concentrations were taken on admission and at 1, 2, 4, 8 and 24 h. The incidence of toxic symptoms was registered during 24 h. There was no significant difference in the area under the plasma drug concentration versus time curve, the peak plasma concentrations or plasma half-lives between the two groups. Toxic symptoms were more frequent in the non-treated groups although this difference was not statistically significant. In patients with TCA overdose initially treated with gastric lavage, a single dose of 20 g of activated charcoal had no effect on the systemic absorption or elimination of TCA.

Antidepressive Agents, Tricyclic↗
PubMed1984

A pharmacokinetic comparison of choline magnesium trisalicylate and soluble aspirin.

Claims that twice-daily dosage of choline magnesium trisalicylate (CMT) may alter salicylate disposal kinetics and result in sustained plasma levels were examined. Plasma levels, urine excretion and pharmacokinetics of salicylate were estimated in six men following the recommended twice-daily dose of CMT and a smaller dose of soluble aspirin. The plasma salicylate levels achieved with CMT were lower than those seen in previous studies but this probably reflected differences of methodology. Salicylate levels were not sustained between doses and elimination rates and half-life were similar for both preparations. No major alteration of disposal kinetics could be demonstrated for CMT with the dose used in the present study.

Administration, Oral↗