Acute propoxyphene hydrochloride intoxication

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Abstract
Severe intoxication may result from propoxyphene hydrochloride ingestion. Respiratory arrest and anoxic brain damage may result from as little as 32 mg/kg. The drug is readily absorbed from the stomach, yet the blood level is low, suggesting that the distribution space is large due to sequestration in the tissue, possibly fat. The quantitative removal by dialysis is also consistent with this concept. Renal excretion is flow dependent, and the clearance averaged 28 ml/min. Cellophane and peritoneal membranes are not significant diffusion barriers to propoxyphene but the clinical benefit from dialysis is limited by the small quantity in circulating blood. The early institution of forced diuresis, peritoneal, and hemodialysis in the severely poisoned patient is advocated. A small quantity of poison removed may have significant clinical effects.

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