The pharmacokinetics and pharmacodynamics of severe aldicarb XXXX after @entity1445 .

@entity410 @entity137 @entity47481 @entity322 @entity1425 @entity772 @entity4968 @entity3897 @entity551 @entity1445
OBJECTIVE: To describe the clinical effects, pharmacokinetics, and pharmacodynamics of plasma and acetylcholinesterase in an aldicarb @entity1445 . CASE REPORT: A 57-year-old female was found unconscious and @entity322 after ingesting @entity47481 . She was bradycardic, @entity551 , hypersalivating, clammy, had small pupils, and generalized weakness. She was intubated, ventilated, and treated with large @entity3897 doses (50 mg and 20 mg/h infusion) and @entity1425 . She improved hemodynamically over 24 h, but remained @entity772 for another 24 h, before recovering without sequela. Aldicarb concentration at admission was 2.18  g/ml and concentration-time data best fitted a two compartmental model with first order absorption and a time of ingestion 4.5 h preadmission. The half-life of distribution was 0.4 h and half-life of elimination, 13 h. Plasma cholinesterase concentration at admission was 0.3 kU/L (Reference range[RR]:4.3-10.6 kU/L) and red cell cholinesterase was 10 U/gHb (RR:38-66 U/gHb). The IC50 was 0.15  g/ml and 0.26  g/ml for plasma and red cell cholinesterase, respectively. DISCUSSION: Aldicarb @entity4968 causes rapid onset severe @entity137 with muscarinic and nicotinic excess, @entity410 , and decreased consciousness. Cholinesterases rapidly recover once aldicarb concentrations decrease and precede clinical recovery.
