Carbamazepine overdose
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Carbamazepine overdose Sudden death An epileptic admitted unconscious 4 hours after swallowing approxi mately 300 carbamazepine 200mg tablets + alcohol died 21 hours after hospitalisation. The 26-year-old had a h i story of reactive depression and had been taking carbamazepine 200mg tid for 4 years when this event occurred. On admission, BP was 125/70mm Hg, heart rate was 100 beats/min sinus rhythm and the patient had a gag reflex and generalised hypotonia. Gastric lavage was performed (with an endotracheal tube in situ) but there was no change in the patient's condition until 17 hours later when grand mal seizures occurred and undigested food was vomited. The subject then progressively deteriorated despite the removal of more tablet debris after passage of a large bore nasogastric tube. Further seizures were refractory to IV diazepam and, after developing respiratory distress and deepening coma, the patient suffered a fatal cardiorespiratory arrest. At necropsy, the carbamazepine serum concentration was 129.5 and no other drugs or pOisons were detected. The only abnormalities observed were a fatty liver, slight cardiac enlargement and aspiration pneumonitis with a very inflamed trachea. The authors concluded that 'aspiration of gastric contents appears to be a major danger which should be prevented as far as possible and intensively treated if it occurs' . Denning. D. w. : Matheson, L. : Bryson. 8 . M. : 8treele. J .; Berry. O.J. et sl. : Human Toxicology 4: 255·260 (May 1985)
Transcript of Carbamazepine overdose
Carbamazepine overdose Sudden death
An epileptic admitted unconscious 4 hours after swallowing approximately 300 carbamazepine 200mg tablets + alcohol died 21 hours after hospitalisation. The 26-year-old had a h istory of reactive depression and had been taking carbamazepine 200mg tid for 4 years when this event occurred.
On admission, BP was 125/70mm Hg, heart rate was 100 beats/min sinus rhythm and the patient had a gag reflex and generalised hypotonia. Gastric lavage was performed (with an endotracheal tube in situ) but there was no change in the patient's condition until 17 hours later when grand mal seizures occurred and undigested food was vomited. The subject then progressively deteriorated despite the removal of more tablet debris after passage of a large bore nasogastric tube. Further seizures were refractory to IV diazepam and, after developing respiratory distress and deepening coma, the patient suffered a fatal cardiorespiratory arrest .
At necropsy, the carbamazepine serum concentration was 129.5 ~molJL and no other drugs or pOisons were detected. The only abnormalities observed were a fatty liver, slight cardiac enlargement and aspiration pneumonitis with a very inflamed trachea.
The authors concluded that 'aspiration of gastric contents appears to be a major danger which should be prevented as far as possible and intensively treated if it occurs' . Denning. D. w.: Matheson, L.: Bryson. 8 .M. : 8treele. J.; Berry. O.J. et sl. : Human Toxicology 4: 255·260 (May 1985)
