Citation

Magdalan J. Advances in Clinical and Experimental Medicine 2005; 14(6): 1345-1348.

Copyright

(Copyright © 2005)

DOI

unavailable

PMID

unavailable

Abstract

The case of a 34-year-old man, dependent on alcohol, who ingested 72 g of slow-release carbamazepine (CBZ) is presented. The patient developed deep coma, skeletal muscle flaccidity with hyporeflexia and arterial hypotonia, with tachycardia. His serum CBZ concentration was unusually high and peaked at 111,0 μg/ml (therapeutic concentration 4-12 μg /ml). The patient required endotracheally intubation. A single-dose of activated charcoal was administered intragastrically on the admision to the Acute Intoxication Unit. The treatment with infusion fluids resulted in fast improvement of the cardiovascular system, but the patient was still comatose. Deep coma persisted to the second day of hospitalization. At day 3, the CBZ concentration fell to 24 μg/ml; this was associated with improvement of the neurological status. The major effects observed in our patient in the next two days were equilibrium disorders, ataxia with dysmetria, and agitation. He required immobilisation and pharmacological sedation. The patient subsequently made a full recovery and confirmed suicidal ingestion of 180 tablets of Tegretol CR 400. In cases of severe intoxications with CBZ extracorporal methods of toxin elimination from the blood may be useful, but according to our experience, even in most serious cases of CBZ intoxication an intensive symptomatic treatment proves usually sufficient. However, confirmation of the effectiveness and safety of the symptomatic treatment compared to extracorporal methods of CBZ elimination requires further clinical research.

Language: pl

Keywords

adult; human; male; alcoholism; case report; suicide attempt; hospitalization; Carbamazepine; article; drug intoxication; sedation; tachycardia; Acute intoxication; coma; activated carbon; drug blood level; carbamazepine; restlessness; cardiovascular disease; neurologic disease; endotracheal intubation; ataxia; infusion fluid; immobilization; muscle hypotonia; Ataxia; dysmetria; flaccid paralysis; High serum concentration; hyporeflexia; single drug dose; slow release formulation; Symptomatic treatment