Acute Oxcarbazepine, Benazepril, and Hydrochlorothiazide Overdose With Alcohol

Furlanut, Mario; Franceschi, Loretta; Poz, Donatella; Silvestri, Luciano; Pecorari, M

doi:10.1097/01.ftd.0000196660.89984.8d

Cited by 19 publications

(12 citation statements)

References 5 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clearance of 10-hydroxycarbazepine is reduced in the elderly [14] and also in the setting of renal insufficiency [124]. There is little data on the effect of hemodialysis on oxcarbazepine or 10-hydroxycarbazepine except for a case report of the successful treatment of massive oxcarbazepine overdose by hemodialysis [125]. The clearance of 10-hydroxycarbazepine is increased in pregnancy [126] and in patients taking liver enzyme-inducing drugs [38].…”

Section: Oxcarbazepinementioning

confidence: 99%

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Krasowski

2010

Pharmaceuticals

View full text Add to dashboard Cite

In the past twenty years, 14 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. In general, the clinical utility of therapeutic drug monitoring has not been established in clinical trials for these new anticonvulsants, and clear guidelines for drug monitoring have yet to be defined. The antiepileptic drugs with the strongest justifications for drug monitoring are lamotrigine, oxcarbazepine, stiripentol, and zonisamide. Stiripentol and tiagabine are strongly protein bound and are candidates for free drug monitoring. Therapeutic drug monitoring has lower utility for gabapentin, pregabalin, and vigabatrin. Measurement of salivary drug concentrations has potential utility for therapeutic drug monitoring of lamotrigine, levetiracetam, and topiramate. Therapeutic drug monitoring of the new antiepileptic drugs will be discussed in managing patients with epilepsy.

show abstract

Section: Oxcarbazepinementioning

confidence: 99%

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Krasowski

2010

Pharmaceuticals

View full text Add to dashboard Cite

show abstract

“…Very few cases of OXC overdose have been reported to date [6][7][8][9]. In all of them, central nervous system depression was rapidly induced and all patients fully recovered with symptomatic and supportive treatment.…”

Section: Figurementioning

confidence: 99%

“…Of note, haemodialysis was not useful in accelerating MHD elimination in an adult patient who had ingested 42 g of OXC, despite this metabolite exhibiting low protein binding, around 40% [7]; nor was plasmapheresis in another patient with MHD steady-state levels [13]. Most of the patients ingested OXC with other drugs known to be central nervous system depressors, such as alcohol [7] or quetiapine [6]. The patient we present had normally received his risperidone dose at the time of OXC overdose; no drug interactions of OXC with risperidone have been described to date [14].…”

Section: Figurementioning

confidence: 99%

“…Although it is unusual to administer multiple doses of activated charcoal to treat poisoning and overdoses, two doses were given in this case based on its use after carbamazepine overdose [12]. Of note, haemodialysis was not useful in accelerating MHD elimination in an adult patient who had ingested 42 g of OXC, despite this metabolite exhibiting low protein binding, around 40% [7]; nor was plasmapheresis in another patient with MHD steady-state levels [13]. Most of the patients ingested OXC with other drugs known to be central nervous system depressors, such as alcohol [7] or quetiapine [6].…”

Section: Figurementioning

confidence: 99%

“…In clinical practice, the most commonly observed adverse events are rash, fatigue, nausea and somnolence [4]. Only four cases of OXC acute overdose have been reported to date [6][7][8][9], none of them in a paediatric patient. We describe the case of a 13-year-old boy who presented with somnolence after the ingestion of 15 g of OXC, and provide concomitant serum concentrations of both OXC and MHD.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Acute oxcarbazepine overdose in an autistic boy

Pedrini

Noguera

Vinent

et al. 2009

Brit J Clinical Pharma

View full text Add to dashboard Cite

Oxcarbazepine (OXC), a 10-keto analogue of carbamazepine, is an antiepileptic drug licensed for the treatment of partial seizures in children and adults, as monotherapy or adjunctive therapy [1]. In humans, OXC is rapidly metabolized in liver to 10-monohydroxy-carbazepine (MHD), its active metabolite. MHD blocks voltage-sensitive sodium channels, stabilizing hyperexcited neuronal membranes, thereby inhibiting repetitive firing and decreasing the propagation of synaptic impulses [2]. Recently, successful use of OXC in the management of disruptive behaviours in autistic patients has also been reported [3].Despite the fact that experience with OXC in the paediatric age is still limited, several observational studies indicate that the drug has a good long-term tolerability profile [4,5]. In clinical practice, the most commonly observed adverse events are rash, fatigue, nausea and somnolence [4]. Only four cases of OXC acute overdose have been reported to date [6][7][8][9], none of them in a paediatric patient. We describe the case of a 13-year-old boy who presented with somnolence after the ingestion of 15 g of OXC, and provide concomitant serum concentrations of both OXC and MHD.A 13-year-old boy (weight 60 kg, height 175 cm) was brought to the Emergency Department by his mother because of accidental ingestion of 250 ml of Trileptal™ suspension (OXC solution, 60 mg l -1 ; Novartis, Barcelona, Spain) 1 h before; he had vomited shortly after the intake. No other drugs had been ingested. The patient had been diagnosed with autism spectrum disorder at the age of 4 years and was receiving risperidone (1 mg three times a day; Risperdal Flas™, Janssen-Cilag, Madrid, Spain) from the age of 10 years, together with behaviour modification. Treatment with OXC (300 mg twice daily) had been implemented 6 months earlier to treat persistent aggression towards others and head banging, with good tolerance to treatment and improvement in his disruptive behaviour.On admission, the patient's vital signs were as follows: blood pressure 105/47; pulse 75 beats min -1 ; respiratory rate 15 breaths min -1 ; haemoglobin saturation while breathing room air, 99%; temperature 36.9°C. He was somnolent (minimal Glasgow Coma Scale 13) but arousable to pain stimuli. Normal tendon and pupillary reflexes were present. Nystagmus and tremor were not observed; gait disturbances were not evaluable. The rest of the physical examination was unremarkable. The ECG was within normal limits (sinus rhythm, QRS 85 ms, and QTc 410 ms), and laboratory testing showed normal values for complete blood count, blood gases, protein and albumin levels, kidney and liver functions, and electrolyte concentrations.

show abstract

Anticonvulsants Used in Child and Adolescent Psychiatric Disorders

Pavuluri

Mayanil

2012

Pharmacotherapy of Child and Adolescent Psychiatric Disorders

View full text Add to dashboard Cite

Acute Oxcarbazepine, Benazepril, and Hydrochlorothiazide Overdose With Alcohol

Cited by 19 publications

References 5 publications

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Acute oxcarbazepine overdose in an autistic boy

Anticonvulsants Used in Child and Adolescent Psychiatric Disorders

Contact Info

Product

Resources

About