Carbamazepine overdose
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Reactions 1360 - 16 Jul 2011 O S Carbamazepine overdose Multiorgan dysfunction, treated with resin haemoperfusion: case report A 48-year-old man developed multiorgan dysfunction following an overdose of carbamazepine, which was successfully treated with resin haemoperfusion. Around 30 hours after the onset of unconsciousness, the man was referred to an emergency department. On examination, he was in a deep coma with diffuse rales bilaterally, diminished bowel sounds, positive Babinski signs bilaterally and grade 0 muscle power in his upper and lower limbs. Laboratory tests results indicated multiorgan dysfunction including respiratory depression and cardiac insufficiency. Questioning revealed the man had a history of cerebral cysticercosis for which he received carbamazepine 2 months earlier [dosage and route not stated]. He was intubated for assisted ventilation and transferred to an ICU where he received supportive measures, diuretics and activated charcoal gastric lavage. The following day, analysis of a sample taken postadmission revealed a serum carbamazepine concentration > 20 mg/L (reference range 4.0–12.0 mg/L) and acute severe carbamazepine poisoning was diagnosed. Resin haemoperfusion was immediately started (approximately 54 hours postingestion), leading to gradual improvement of laboratory parameters. The man’s serum carbamazepine concentration decreased to 15.32 mg/L after the first course of haemoperfusion and was within therapeutic limits after a second course. His level of consciousness had improved by hospital day 5 and he awoke on day 6 after receiving four courses. He was discharged without major sequelae 10 days postadmission; he did have some lower limb sensory impairment. Li TG, et al. Acute carbamazepine poisoning treated with resin hemoperfusion successfully. American Journal of Emergency Medicine 29: 518-522, No. 5, Jun 2011. Available from: URL: http://dx.doi.org/10.1016/j.ajem.2009.12.006 - China 803057358 1 Reactions 16 Jul 2011 No. 1360 0114-9954/10/1360-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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Transcript of Carbamazepine overdose
Reactions 1360 - 16 Jul 2011
O SCarbamazepine overdose
Multiorgan dysfunction, treated with resinhaemoperfusion: case report
A 48-year-old man developed multiorgan dysfunctionfollowing an overdose of carbamazepine, which wassuccessfully treated with resin haemoperfusion.
Around 30 hours after the onset of unconsciousness, theman was referred to an emergency department. Onexamination, he was in a deep coma with diffuse ralesbilaterally, diminished bowel sounds, positive Babinskisigns bilaterally and grade 0 muscle power in his upper andlower limbs. Laboratory tests results indicated multiorgandysfunction including respiratory depression and cardiacinsufficiency. Questioning revealed the man had a historyof cerebral cysticercosis for which he receivedcarbamazepine 2 months earlier [dosage and route notstated]. He was intubated for assisted ventilation andtransferred to an ICU where he received supportivemeasures, diuretics and activated charcoal gastric lavage.The following day, analysis of a sample takenpostadmission revealed a serum carbamazepineconcentration > 20 mg/L (reference range 4.0–12.0 mg/L)and acute severe carbamazepine poisoning was diagnosed.
Resin haemoperfusion was immediately started(approximately 54 hours postingestion), leading to gradualimprovement of laboratory parameters. The man’s serumcarbamazepine concentration decreased to 15.32 mg/Lafter the first course of haemoperfusion and was withintherapeutic limits after a second course. His level ofconsciousness had improved by hospital day 5 and heawoke on day 6 after receiving four courses. He wasdischarged without major sequelae 10 days postadmission;he did have some lower limb sensory impairment.Li TG, et al. Acute carbamazepine poisoning treated with resin hemoperfusionsuccessfully. American Journal of Emergency Medicine 29: 518-522, No. 5, Jun2011. Available from: URL: http://dx.doi.org/10.1016/j.ajem.2009.12.006 -China 803057358
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Reactions 16 Jul 2011 No. 13600114-9954/10/1360-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
