Successful Treatment of Massive Carbamazepine Overdose
Successful Treatment of Massive Carbamazepine Overdose
复制标题
成功治疗大量卡马西平过量
DOI：
10.1111/j.1528-1157.1989.tb05284.x
复制
发表时间：
1989
期刊：
影响因子：
5.6
通讯作者：
H. Kutt
中科院分区：
文献类型：
--
作者：
M. Sethna;Gail E. Solomon;J. Cedarbaum;H. Kutt
摘要：过量服用卡马西平 (CBZ) 可能致命。我们报告了一名患者因药物吸收延迟而出现近乎致命毒性的病例。一名 36 岁女性因昏迷、低血压和异常运动入院。几个小时后卡马西平 (CBZ) 水平为 36 mg/L。洗胃未发现药丸碎片，并给予活性炭。 CBZ 水平最初下降，入院 36 小时后达到 28 mg/L。随后血药浓度急剧上升，入院后64小时达到54 mg/L。上升的模式表明药物的重新吸收。给予强力泻药，并给予更多剂量的木炭。腹泻发生后三小时，出现眼球转动。两个小时后，她痛苦地龇牙咧嘴。腹泻发生八小时后，她醒了。对于 CBZ 过量，活性炭治疗加上积极的肠道净化有助于防止药物的持续吸收、后期症状恶化和潜在的致命后果。
Summary: Overdose of carbamazepine (CBZ) can be fatal. We report the case of a patient with near‐lethal toxicity due to delayed absorption of drug. A 36‐year‐old woman was admitted with coma, hypotension, and unusual movements. Carbamazepine (CBZ) level several hours later was 36 mg/L. Gastric lavage revealed no pill fragments, and activated charcoal was administered. CBZ level initially fell, reaching 28 mg/L 36 h after admission. Blood level then rose sharply, reaching 54 mg/L 64 h after admission. The pattern of rise suggested renewed absorption of drug. Vigorous cathartics were given, and further doses of charcoal were administered. Three hours after onset of diarrhea, roving eye movements occurred. Two hours later she grimaced to pain. Eight hours after the onset of diarrhea, she was awake. In CBZ overdose, activated charcoal therapy coupled with aggressive intestinal purging helps prevent continued absorption of drug, late exacerbation of symptoms, and potentially fatal outcome.