Carbamazepine overdose
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Reactions 675 - 1 Nov 1997 S Carbamazepine overdose Acute interstitial pneumonia: case report A 36-year-old woman developed acute interstitial pneumonia on 2 occasions after attempting suicide by ingesting an overdose of carbamazepine. On the first occasion, the woman was hospitalised in an unconscious state 5 hours after she had ingested 60 carbamazepine 200mg tablets. She had hypertonia, areflexia and intermittent extensor spasms. She was intubated and treated with gastric aspiration and haemodialysis. Her plasma carbamazepine concentration was 85 mg/L (therapeutic concentration 5–10). Despite these measures, the woman developed progressive respiratory failure 48 hours after hospital admission and required mechanical ventilation. A chest x-ray showed alveolar shadows in both lungs and a chest CT scan showed extensive ground-glass opacity, small nodular opacities and pleural effusions bilaterally. Her lactate dehydrogenase level was elevated and she had a low serum albumin level. Thirteen days after hospital admission, an open lung biopsy was performed and revealed diffuse alveolar damage. The woman was treated with supportive care. She was extubated 19 days after hospitalisation and her lung function had normalised 3 months later. Fifteen months after the first overdose, the woman was rehospitalised after ingesting another overdose of carbamazepine [dose not stated]. Her peak plasma carbamazepine concentration was 52 mg/L. Her clinical course was similar to the first episode and she required mechanical ventilation for 10 days in addition to haemodialysis. She was also treated with corticosteroids. The woman left hospital 2 days after extubation and was lost to follow-up. Wilschut FA, et al. Recurrent respiratory distress associated with carbamazepine overdose. European Respiratory Journal 10: 2163-2165, Sep 1997 - Netherlands 800619482 1 Reactions 1 Nov 1997 No. 675 0114-9954/10/0675-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine overdose
Reactions 675 - 1 Nov 1997
SCarbamazepine overdose
Acute interstitial pneumonia: case reportA 36-year-old woman developed acute interstitial
pneumonia on 2 occasions after attempting suicide byingesting an overdose of carbamazepine.
On the first occasion, the woman was hospitalised in anunconscious state 5 hours after she had ingested 60carbamazepine 200mg tablets. She had hypertonia, areflexiaand intermittent extensor spasms. She was intubated andtreated with gastric aspiration and haemodialysis. Her plasmacarbamazepine concentration was 85 mg/L (therapeuticconcentration 5–10).
Despite these measures, the woman developed progressiverespiratory failure 48 hours after hospital admission andrequired mechanical ventilation. A chest x-ray showed alveolarshadows in both lungs and a chest CT scan showed extensiveground-glass opacity, small nodular opacities and pleuraleffusions bilaterally. Her lactate dehydrogenase level waselevated and she had a low serum albumin level.
Thirteen days after hospital admission, an open lung biopsywas performed and revealed diffuse alveolar damage. Thewoman was treated with supportive care. She was extubated19 days after hospitalisation and her lung function hadnormalised 3 months later.
Fifteen months after the first overdose, the woman wasrehospitalised after ingesting another overdose ofcarbamazepine [dose not stated]. Her peak plasmacarbamazepine concentration was 52 mg/L. Her clinical coursewas similar to the first episode and she required mechanicalventilation for 10 days in addition to haemodialysis. She wasalso treated with corticosteroids. The woman left hospital 2days after extubation and was lost to follow-up.Wilschut FA, et al. Recurrent respiratory distress associated with carbamazepineoverdose. European Respiratory Journal 10: 2163-2165, Sep 1997 -Netherlands 800619482
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Reactions 1 Nov 1997 No. 6750114-9954/10/0675-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
