Reactions 426 - 7 Nov 1992

Carbamazepine overdose

Adverse effects related to serum concentrations inchildren: clinical study

Patients with serum carbamazepine levels of approximately100 micromol/L should be monitored closely and treated withgastric lavage and/or activated charcoal, whereas patients withlevels of approximately 150 micromol/l may require intensivelife support. This was recommended by Mr J Tibballs from theRoyal Children’s Hospital, Melbourne, Australia, based onresults of a study of 82 children (1-17 years of age) admittedwith carbamazepine poisoning. Ten children in a deep comahad a mean peak serum carbamazepine level of 213micromol/L. Six of these patients experienced seizures, 8required mechanical ventilation and 4 required inotropic-vasopressor support; 2 patients died of left ventricular failureand aspiration pneumonitis, respectively. 27 patients in amoderate coma had a mean serum carbamazepine level of 112micromol/L Tachycardia was common in these patients and 2experienced seizures Treatment in this group consisted ofintensive nursing, gastric lavage and activated charcoal. In 45children with a mean serum carbamazepine level of 73micromol/L, symptoms experienced included drowsiness,ataxia, nystagmus, dystonia, vomiting and occasionallyhallucinations. Nine of these patients were treated with emesisor gastric lavage and activated charcoalTibballs J. Acute toxic reaction to carbamazepine: clinical effects and serumconcentrations. Journal of Pediatrics 121: 295-299, Aug 1992 -Australia 800163306

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Reactions 7 Nov 1992 No. 4260114-9954/10/0426-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved