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May 1958

Acute Glutethimide (Doriden) Poisoning: The Use of Bemegride (Megimide) and Hemodialysis

Author Affiliations

Washington, D. C.

From the Department of Medicine and the Renal Laboratory, Georgetown University Medical Center. Assistant Professor of Medicine, Director, Renal Clinic (Dr. Schreiner); Instructor in Medicine and Postgraduate Fellow, National Heart Institute (Berman); Clinical Fellow, Renal Laboratory (Dr. Kovach and Dr. Bloomer).

AMA Arch Intern Med. 1958;101(5):899-911. doi:10.1001/archinte.1958.00260170055008

Glutethimide (Doriden)* has had an unusually rapid and widespread introduction into clinical medicine as a hypnotic and sedative. Chemically, glutethimide is α-ethyl-α-phenylglutarimide whose structual formula is depicted in Figure 1. It is a white crystalline compound with a melting point of 83-85 C and a molecular weight of 217.3. It is

Fig. 1.  —Chemical structures of glutethimide (Doriden, α-ethyl-α-phenylglutarimide) phenobarbital, and bemegride (Megimide, β-methyl-β-ethylglutarimide). very poorly soluble in water but highly soluble in alcohol and acetone. In large doses, the gastric absorption may be irregular and produce variations in the LD50 obtained after oral administration in animals (0.6 gm. per kilogram in the rat and rabbit, 0.5 gm. per kilogram in the dog, and 0.15 gm. per kilogram in the mouse). The problem of absorption also makes it difficult to establish dose-toxicity relationships in human glutethimide poisoning. Once absorbed, glutethimide is eventually excreted in the bile, and up to

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