Abstract
Since experience with primary and secondary detoxification in severe flecainide intoxications is limited, 2 different cases of flecainide intotoxications are reported. In the first case, with plasma concentrations of 6500 ng/ml (therapeutic range: 200–980 ng/ml), the patient survived with a pacemaker and catecholamine support. In the second case, hemoperfusion terminated the need for emergency resuscitation during the initial phase, but was unsuccessful 3 h later. Even with a lower plasma concentration the patient died. Both patients had rapid onset of symptoms due to the very good bioavailability of the drug. Although it may be a rare in toxication, it is dangerous because of its quick onset and its efficiency in altering the cardiac stability. We recommend the prophylactic use of a pacemaker and gastric suction. The usefulness of hemoperfusion has not yet been proven.
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Götz, D., Pohle, S. & Barckow, D. Primary and secondary detoxification in severe flecainide intoxication. Intensive Care Med 17, 181–184 (1991). https://doi.org/10.1007/BF01704725
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DOI: https://doi.org/10.1007/BF01704725