Carbamazepine overdose. Features of 33 cases.
Review of the medical records of 2 major adult teaching hospitals for a 4-year period revealed 33 instances of carbamazepine overdose. These patients had a mean age of 30 years and 58% were known epileptics. They ingested a mean of 12g carbamazepine (range 1.6 to 45g), with 51% of cases involving other drugs, particularly alcohol. The clinical manifestations of toxicity formed a recognisable clinical picture of diminished conscious state (100% of patients), mydriasis (42%), abnormal muscle tone and tendon reflexes (55%) and ataxia, nystagmus or ophthalmoplegia (48%). 24% of cases were complicated by seizures. The incidence of hyperglycaemia and hypokalaemia were related to higher drug concentrations. 12% showed hyponatraemia and 50% had transient evidence of hepatic dysfunction. The pharmacokinetic properties of carbamazepine play a role in determining management strategies. Management is largely supportive through avoidance of drug interactions, large doses of activated charcoal, careful airway management and correction of electrolyte disturbances.
Seymour
J F
JF
Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002220:Carbamazepine / Q000506:poisoning*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D011041:Poisoning / Q000453:epidemiology
D002220:Carbamazepine