[Extended hemoperfusion in the treatment of acute carbamazepine intoxication].
Carbamazepine is used in the treatment of epilepsy, and also prescribed in neuralgic pain syndromes, and certain affective disorders. Carbamazepine intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, arrhythmia, hemodynamic instability and death. The drug's relatively high molecular weight, elevated volume of distribution and intense protein-binding render it difficult to extracorporeal removal, but published experience with hemoperfusion or hemodialysis present variable results. We describe a case report involving carbamazepine intoxication who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of carbamazepine was reduced with rapid lowering of carbamazepine levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, extended charcoal hemoperfusion should be considered for serious carbamazepine intoxication because free as well as bound drug fractions are eliminated via this technique.
Peces
R
R
Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain. cpeces@varnet.com
Azorín
S
S
Peces
C
C
Selgas
R
R
D000208:Acute Disease; D000328:Adult; D002220:Carbamazepine / Q000506:poisoning*; D005260:Female; D006464:Hemoperfusion / Q000379:methods; D006801:Humans; D011041:Poisoning / Q000188:drug therapy; D013406:Suicide, Attempted
D002220:Carbamazepine