Accidental clozapine intoxication in a toddler: Clinical and pharmacokinetic lessons learnt

Journal of Clinical Pharmacy and Therapeutics

Volumn 38, Issue 2, 2013, Pages 165-168

  Toepfner, N ^a   Wohlfarth, A ^b   Naue, J ^c   Auwarter V ^c   Berner, R ^a   Hermanns Clausen, M ^c  

^a DRESDEN UNIVERSITY OF TECHNOLOGY   (Germany)

^b NATIONAL INSTITUTE ON DRUG ABUSE   (United States)

^c UNIVERSITY OF FREIBURG   (Germany)

Author keywords

accidental; clozapine N oxide; CYP450; norclozapine; overdose

Indexed keywords

ANTIBIOTIC AGENT; CEFACLOR; CLOZAPINE; CLOZAPINE N OXIDE; CYTOCHROME P450 1A2; NORCLOZAPINE; NEUROLEPTIC AGENT;

ALERTNESS; ANTIBIOTIC THERAPY; AROUSAL; ARTICLE; ATELECTASIS; BRAIN DISEASE; CASE REPORT; CHILD; COMA; COMA OF UNKNOWN ORIGIN; CYANOSIS; DRUG BLOOD LEVEL; DRUG CEREBROSPINAL FLUID LEVEL; DRUG ELIMINATION; DRUG INTOXICATION; DRUG OVERDOSE; DRUG SCREENING; DRUG URINE LEVEL; DYSARTHRIA; DYSPNEA; ELECTROENCEPHALOGRAM; FEMALE; GLASGOW COMA SCALE; HUMAN; LIQUID CHROMATOGRAPHY; OXYGEN THERAPY; PRESCHOOL CHILD; RESPIRATORY FAILURE; SOMNOLENCE; TACHYCARDIA; TACHYPNEA; TANDEM MASS SPECTROMETRY; THORAX RADIOGRAPHY; TODDLER; UPPER RESPIRATORY TRACT INFECTION; ACCIDENT; BLOOD; INFANT;

ACCIDENTS; ANTIPSYCHOTIC AGENTS; CLOZAPINE; FEMALE; HUMANS; INFANT;

EID: 84874969546     PISSN: 02694727     EISSN: 13652710     Source Type: Journal    
DOI: 10.1111/jcpt.12022     Document Type: Article

References (14)

1. Gogtay N, Rapoport J,. Clozapine use in children and adolescents. Expert Opin Pharmacother, 2008; 9: 459-465.
2. Burns MJ,. The pharmacology and toxicology of atypical antipsychotic agents. J Toxicol Clin Toxicol, 2001; 39: 1-14.
3. Burn MJ,. Neuroleptic agents. In:, Brent J, Wallace K, Burkhart K, et al., eds. Critical care toxicology: diagnosis and management of the critically poisoned patient, 1st edn. Philadelphia: Elsevier, 505-522, 2005.
4. Antia SX, Sholevar EH, Baron DA,. Overdoses and ingestions of second-generation antipsychotics in children and adolescents. J Child Adolesc Psychopharmacol, 2005; 15: 970-985.
5. Wohlfarth A, Naue J, Lutz-Bonengel S, Dresen S, Auwarter V,. Cocktail approach for in vivo phenotyping of 5 major CYP450 isoenzymes: development of an effective sampling, extraction, and analytical procedure and pilot study with comparative genotyping. J Clin Pharmacol, 2012; 52: 1772-1773.
6. The Human Cytochrome P450 (CYP) Allele Nomenclature Database. Available at: http://www.cypalleles.ki.se/ (accessed: 17 June 2012).
7. Wohlfarth A, Toepfner N, Hermanns-Clausen M, Auwarter V,. Sensitive quantification of clozapine and its main metabolites norclozapine and clozapine-N-oxide in serum and urine using LC-MS/MS after simple liquid-liquid extraction work-up. Anal Bioanal Chem, 2011; 400: 737-746.
8. Toennes SW, Maurer HH,. Microsoft Excel in pharmacokinetics-an easy way to solve kinetic problems in clinical toxicology, legal medicine or doping control. In:, Sachs H, Bernhard W, Jeger A, eds. Proceedings to 34th International TIAFT Meeting, Interlaken, 11-15 August 1996. Leipzig: Molina, 201-204, 1997.
9. Borzutzky A, Avello E, Rumie H, Paris E,. Accidental clozapine intoxication in a ten-year-old child. Vet Hum Toxicol, 2003; 45: 309-310.
10. Mady S, Wax P, Wang D, Goetz C, Hadley C, Love R,. Pediatric clozapine intoxication. Am J Emerg Med, 1996; 14: 462-463.
11. KLASCO Monograph Clozapine DRUGDEX® System, Vol. 150, Thomson Reuters, Greenwood Village, Colorado.
12. Mendoza MC, Lindenmayer JP,. N-desmethylclozapine: is there evidence for its antipsychotic potential? Clin Neuropharmacol, 2009; 32: 154-157.
13. Jaquenoud Sirot E, Knezevic B, Morena GP, et al. ABCB1 and cytochrome P450 polymorphisms: clinical pharmacogenetics of clozapine. J Clin Psychopharmacol, 2009; 29: 319-326.
14. Renwick AC, Renwick AG, Flanagan RJ, Ferner RE,. Monitoring of clozapine and norclozapine plasma concentration-time curves in acute overdose. J Toxicol Clin Toxicol, 2000; 38: 325-328.