The influence of carbamazepine plasma level on blood pressure and some ECG parameters in patients with acute intoxication.
BACKGROUND
Carbamazepine (CBZ) is an antiepileptic drug with tricyclic structure which implies its potential cardinotxic properties, especially in acute poisoning.


OBJECTIVE
To evaluate some cardiovascular effects connected with CBZtoxicity and tofind the relation between them and CBZ plasma level.


METHODS
34 patients (18 males, 16 females; median age 24.5) hospitalized in our Department in 1996-1997 and 2005-2006 due to acute CBZ poisoning. Analysis included following parameters: systolic (SBP) and diastolic (DBP) blood pressure, ECG parameters: heart rate (HR), duration of QRS complex, PQ interval and corrected QT interval (QTc) calculated with Bazett's (QTc(B)) and Hodges's (QTc(H)) formulas. These parameters were compared with reference values for general population available in the literature. Relations between above mentioned parameters and CBZ plasma level were studied by means of Generalized Additive Model (GAM).


RESULTS
The reference values were exceeded most often for QRS (62%), DBP and QTc(B) (53%, both) and SBP (50%). The mean number of parameters with exceeded norms was 3.1 per patient (SD = 1.71). We failed to find any significant correlation between CBZ plasma level and any of the studied parameters. Positive correlation between SBP and DBP (r = 0.68; p < 0.001) and negative correlation between QRS and HR (r = -0.50; p = 0.003) were found.


CONCLUSIONS
CBZ could affect different cardiovascular parameters which should be monitored in cases of acute drug poisonings.
Ciszowski
Krzysztof
K
wt_poohatek@wp.pl
Szpak
Dorota
D
Jenner
Bartosz
B
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000097:blood* / Q000506:poisoning*; D001783:Blood Flow Velocity / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002220:Carbamazepine / Q000097:blood* / Q000506:poisoning*; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry / Q000378:metabolism; D012189:Retrospective Studies
D000929:Antidepressive Agents, Tricyclic; D002220:Carbamazepine