Intravenous DOPG liposomes do not augment pH gradient liposome supported peritoneal dialysis in treatment of acute intravenous amitriptyline intoxication in rats

Figures & data

Figure 1. (a) Amitriptyline in blood exists as protein bound and unbound. Unbound amitriptyline equlibrates between blood and peritoneal dialysate. (b) Addition of liposomes with acidic core in peritoneal dialysate increases the gradient from blood to dialysate. Protein-bound amitriptyline is in equilibrium with unbound amitriptyline and releases amitriptyline in the blood. (c) Amitriptyline-binding DOPG liposomes in the blood increase the blood amitriptyline concentration. Study question: Does addition of amitriptyline-binding DOPG liposomes in the blood promote extraction of amitriptyline into dialysate?

Table 1. Baseline and physiologic data (shown as median [IQR]).

	Control (n = 7)	IV liposomes (n = 5)
Age (days)	210 (171–222)	210 (191–210)
Weight (gm)	360 (342–380)	400 (373–403)
MAP pre amitrip (mmHg)	74 (66–92)	83 (83–90)
MAP post amitrip	58 (56–62)	64 (60–66)
MAP 10 min post amitrip	63 (61–66)	73 (63–74)

Pre-amitrip = timepoint immediately prior to amitriptyline injection.

MAP post amitrip = timepoint immediately post completion of amitritptyline injection.

MAP 10 min post amitrip = timepoint 10 min post completion amitriptyline injection.

Figure 2. Blood concentrations of amitriptyline over the time period of the peritoneal dwell.

Figure 3. Average blood amitriptyline concentration over the period of the peritoneal dwell, and dialysate concentration of amitriptyline at the end of the peritoneal dwell.

Figure 4. Estimated extraction ratio for amitriptyline from peritoneal bloodflow into dialysate for controls and IV DOPG liposome pre-treated subjects.