scholarly journals Successful Treatment of Intrathecal Methotrexate Overdose by Using Ventriculolumbar Perfusion and Intrathecal Instillation of Carboxypeptidase G2

1996 ◽  
Vol 71 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Aengus S. O'Marcaigh ◽  
Christopher M. Johnson ◽  
William A. Smithson ◽  
Marc C. Patterson ◽  
Brigitte C. Widemann ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Intrathecal Methotrexate ◽  
Carboxypeptidase G2

Successful treatment of intrathecal methotrexate overdose with folinic acid rescue: a case report

2007 ◽  
Vol 88 (7) ◽  
pp. 780-782 ◽  
Author(s):  
L Riva ◽  
V Conter ◽  
C Rizzari ◽  
M Jankovic ◽  
A Sala ◽  
...  
Keyword(s):  
Case Report ◽  
Folinic Acid ◽  
Successful Treatment ◽  
Intrathecal Methotrexate ◽  
Folinic Acid Rescue

Rescue of experimental intrathecal methotrexate overdose with carboxypeptidase-G2.

1991 ◽  
Vol 9 (4) ◽  
pp. 670-674 ◽  
Author(s):  
P C Adamson ◽  
F M Balis ◽  
C L McCully ◽  
K S Godwin ◽  
J D Bacher ◽  
...  
Keyword(s):  
Macaca Mulatta ◽  
Rhesus Monkeys ◽  
Intrathecal Methotrexate ◽  
Dose Equivalent ◽  
Carboxypeptidase G2 ◽  
Important Addition ◽  
Csf Pharmacokinetics ◽  
Rescue Agent

The carboxypeptidase G class of enzymes rapidly hydrolyze methotrexate (MTX) into the inactive metabolites 4-deoxy-4-amino-N10-methylpteroic acid (DAMPA) and glutamate. This study evaluated the use of carboxypeptidase-G2 (CPDG2) as a potential intrathecal (IT) rescue agent for massive IT MTX overdose. The CSF pharmacokinetics of MTX with and without CPDG2 rescue was studied in adult rhesus monkeys (Macaca mulatta) using a nontoxic IT 5 mg dose (equivalent to 50 mg in humans). Without CPDG2 rescue, peak CSF MTX concentration was 2,904 +/- 340 mumol/L. Within 5 minutes of administration of 30 U IT CPDG2, CSF MTX concentrations decreased greater than 400-fold to 6.55 +/- 6.7 microM. Subsequently, groups of three monkeys received either 25 mg IT MTX (equivalent to 250 mg in humans) followed by 150 U IT CPDG2 or 50 mg IT MTX (equivalent to 500 mg in humans) followed by 300 U IT CPDG2. All animals survived without neurotoxicity. Our studies suggest that CPDG2 may prove to be an important addition to the currently recommended strategy for the management of IT MTX overdose.

scholarly journals Treatment of Accidental Intrathecal Methotrexate Overdose With Intrathecal Carboxypeptidase G2

2004 ◽  
Vol 96 (20) ◽  
pp. 1557-1559 ◽  
Author(s):  
B. C. Widemann ◽  
F. M. Balis ◽  
A. Shalabi ◽  
M. Boron ◽  
M. O'Brien ◽  
...  
Keyword(s):  
Intrathecal Methotrexate ◽  
Carboxypeptidase G2
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