Treatment of ciprofloxacin poisoning
1: Stabilization and cleaning of the digestive tract. When treating an overdose, ipecac syrup is not recommended, since the peak plasma level is reached within 1 hour after administration, and in addition, there is a risk of seizures. Gastric lavage is potentially useful if no more than 2 hours have passed since ingestion, but should be accompanied by tracheal protection to avoid aspiration pneumonitis induced by early attacks. There is no evidence of the effectiveness of activated carbon and laxatives.
2. Strengthening the elimination. A large volume of distribution usually reduces the effectiveness of hemodialysis and hemoperfusion.
3. Antidotes. Antidotes are not known.
4. Supportive care for ciprofloxacin poisoning:
– Seizures. Seizures can be stopped with diazepam, phenytoin and other anticonvulsants.
– Renal dysfunction. A thorough regular examination of renal function is recommended (urinalysis for crystalluria, determination of serum levels of creatinine and blood urea nitrogen). Adequate hydration (infusion therapy) and accurate measurement of the incoming and released fluid are required. Steroid therapy can relieve interstitial nephritis and arthralgia.
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Laboratory data on ciprofloxacin poisoning
- Analytical methods. For the quantitative determination of ciprofloxacin in plasma, whole blood and human red blood cells, there is a method of high-performance liquid chromatography with fluorescence detection. The limit of its sensitivity for this substance is 25 ng / ml. Apparently, the method is suitable for its therapeutic monitoring.
2. Blood levels. A day after oral administration of 21 g of ciprofloxacin (28 tablets of 750 mg each), its serum level corresponded to 3 μg / ml.
3. Anomalies. Eosinophilia, neutropenia, increased transaminase activity and serum creatinine levels were noted.
Supporting research . Ciprofloxacin may exhibit pseudoglycosuria in urinalysis with the BM-Test-7 (Boeringeg — Mannheim) instrument, which uses a specific glucose oxidase / peroxidase reaction. It is possible that this result is due to one of the antibiotic metabolites, since the test directly with ciprofloxacin is negative.