Title of article :
Pediatric Carbamazepine Intoxication, ,
Author/Authors :
Ernest S Stremski، نويسنده , , William B Brady، نويسنده , , Kris Prasad، نويسنده , , Halim A Hennes، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1995
Abstract :
Study objective: To describe the clinical effects of carbamazepine ingestion in a pediatric population.
Design: Case series of prospectively evaluated patients and a historical retrospective group.
Participants: All patients younger than 18 years who presented to an urban emergency department with history of carbamazepine ingestion and positive laboratory confirmation.
Interventions: Patient demographics, findings on physical examination, serum carbamazepine levels, analysis of 12-lead ECGs, and time and doses of activated charcoal were recorded.
Results: Seventy-seven patients were enrolled, of whom 17 were evaluated prospectively. Serum carbamazepine levels were greater than 12 μg/mL (50 μmol/L) in 61 patients. In those 61 patients, mean peak serum level was significantly higher in patients with dystonic reactions (P =.009), coma (P =.002), and apnea (P =.008) than in patients without these symptoms. There was no significant difference in mean peak serum levels between patients with and without seizures. Serum carbamazepine half-life was significantly shorter (P =.022) in patients who received multiple doses of activated charcoal (8.2±1.6 hours) than in those who received a single dose (12.1±4.9 hours).
Conclusion: Pediatric patients with suspected carbamazepine ingestion are at higher risk for dystonic reactions, coma, and apnea if the peak serum carbamazepine level exceeds 28 μg/mL (117 μmol/L). The development of seizures is not related to peak serum level. Multiple doses of activated charcoal can significantly shorten serum carbamazepine half-life.
Journal title :
Annals of Emergency Medicine
Journal title :
Annals of Emergency Medicine