Carbamazepine overdose
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Carbamazepine overdose Death: case report A 34-year-ol d m an was hospitali sed with seizures and delirium . He had a hist or y of long term seizu re disorders and had been re ceiving carbamazepine monotherapy, or in combination with lorazepam, for 5 years. Carbamazepine levels had ranged from 1.9 to 14.3 mg/ L reflecting poor compliance. On the day of admission , the patient had become ataxic and delirious and had several tonic clonic seizures. 1M diazepam 20mg was administered before he was taken to hospital. An empty bottle of carbamazepine (,Tegretol ') was later found in his room, but the precise time of ingestion was unknown. In the hospital, the patient became agitated, delirious and unresponsive to commands; BP was 160/80mm Hg, respiratory rate 20/ min and HR 120/ min . The initial diagnosis was non -convulsive status epilepticus and delirium . Phenytoin was administered to stop seizure frequency, but thrashing continued . Breathing became irregular and he became cyanotic 6 hours after admission; oxygen was given by ventilator. Serum carbamazepine on admission was found to be 54 mg/L, and gastric lavage was performed , followed by 2 doses of activated charcoal. The patient continued to deteriorate even though serum carbamazepine levels graduall y declined. He developed fever, hypotension, ventricular premature contractions and on-going tonic clonic seizures. The patient died on day 4. Postmortem revealed acute tubular necrosis, hepatocellular necrosis and hypoplasia of the bilateral temporal gyri. Fisher RS . Cysyk B A fatal overdose of carbamazeplne case report and review of literature Clinical TOXicology 26 447-486. No 1988 [35 references J 906 '
Transcript of Carbamazepine overdose
Carbamazepine overdose Death: case report
A 34-year-old man was hospitalised with seizures and delirium. He had a history of l ong term seizure disorders and had been receiving carbamazepine monotherapy, or in combination with lorazepam, for 5 years . Carbamazepine levels had ranged from 1.9 to 14.3 mg/ L reflecting poor compliance.
On the day of admission , the patient had become ataxic and delirious and had several tonic clonic seizures. 1M diazepam 20mg was administered before he was taken to hospital. An empty bottle of carbamazepine (,Tegretol ') was later found in his room , but the precise time of ingestion was unknown. In the hospital , the patient became agitated , delirious and unresponsive to commands; BP was 160/80mm Hg, respiratory rate 20/ min and HR 120/ min .
The initial diagnosis was non-convulsive status epilepticus and delirium . Phenytoin was administered to stop seizure frequency, but thrashing continued . Breathing became irregular and he became cyanotic 6 hours after admission ; oxygen was given by ventilator. Serum carbamazepine on admission was found to be 54 mg/ L, and gastric lavage was performed , followed by 2 doses of activated charcoal. The patient continued to deteriorate even though serum carbamazepine levels gradually declined . He developed fever, hypotension, ventricular premature contractions and on-going tonic clonic seizures.
The patient died on day 4. Postmortem revealed acute tubular necrosis, hepatocellular necrosis and hypoplasia of the bilateral temporal gyri. Fisher RS. Cysyk B A fatal overdose of ca rbamazeplne case report and review of literature Clinical TOXicology 26 447-486. No 1988 [35 references J 906 '
