Efficacy of hemodialysis and charcoal hemoperfusion in carbamazepine overdose

Pilapil, Maricel; Petersen, Jeffrey

doi:10.1080/15563650701264300

Cited by 21 publications

(19 citation statements)

References 6 publications

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“…8 In rare and severe poisoning, because carbamazepine is amendable to hemodialysis, aggressive enhancement of elimination via this technique may also be entertained. 9 Hemodialysis occurred solely in our patient subgroup (3 patients) that initially arrived with supratherapeutic concentrations that continued to rise to colossal levels of 57-68 mg/mL. Interestingly, 27 of these patients did become progressively ill enough to require intubation at some point during their course.…”

Section: Discussionmentioning

confidence: 88%

Delayed Elevation in Carbamazepine Concentrations After Overdose

Patel

Schindlbeck

Bryant

2013

American Journal of Therapeutics

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An initial carbamazepine concentration may initially be supratherapeutic, therapeutic, or even subtherapeutic only to persist to rise over time. The aim of this study was to report the frequency of toxic carbamazepine concentrations continuing to rise and to estimate how often an initially therapeutic or subtherapeutic concentration misrepresents the potential toxicity of an acute carbamazepine overdose. An 8-year retrospective search of all carbamazepine exposures reported to the Illinois Poison Center (January 1, 2001 through December 31, 2008) was reviewed. Inclusion criteria were acute poisonings with a documented carbamazepine concentration of >12 μg/mL at any time. Those with initial concentrations of >12 μg/mL that subsequently increased over time were recorded. Additionally, those cases that initially had therapeutic (4-12 μg/mL) or subtherapeutic (<4 μg/mL) concentration were identified. Descriptive statistics were used to analyze the data. A total of 1424 cases were reported. Of the 523 patients with documented concentrations of >12 μg/mL, 93 patients (17.8%) had initial carbamazepine concentrations >12 μg/mL and continued to rise. Sixteen patients (3.5%) had initial carbamazepine concentrations that were therapeutic (4-12 μg/mL) and 7 patients (1.3%) had initial carbamazepine concentrations <4 μg/mL before rising >12 μg/mL. Certain patients had progressive decreases in level of consciousness corresponding to increasing carbamazepine concentrations. Additionally, several patients with initial levels of therapeutic or subtherapeutic concentration later became comatose and required ventilator management. Initial serum carbamazepine concentrations can be misleading. Serial measurements documenting a declining carbamazepine concentration or prolonged observation are recommended when managing these overdoses.

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Section: Discussionmentioning

confidence: 88%

Delayed Elevation in Carbamazepine Concentrations After Overdose

Patel

Schindlbeck

Bryant

2013

American Journal of Therapeutics

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“…Highly protein bound toxins, depending on the affinity to the charcoal, in CH will competitively separate from the protein and adsorb to the charcoal for removal. [6][7][8] The use of CH in veterinary medicine is still applicable and is often combined with other RRT modalities. In this modality, as the free toxin crosses the membrane to bind with albumin in the dialysate, the concentration gradient will change and more toxin will dissociate from the albumin in the blood and will contribute to a greater clearance of toxin.…”

Section: Methodsmentioning

confidence: 99%

Blood Purification for Intoxications and Drug Overdose

Palm¹,

Kanakubo

2015

Small Animal Critical Care Medicine

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“…[2] 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 show variable results. [3] In this paper, we report a 19-year-old woman with fatal-dose carbamazepin intoxication who was treated successfully with multiple-dose activated charcoal and hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of excessive dose of carbamazepine

Yaylacı¹,

Demır²,

Acar³

et al. 2012

Indian J Pharmacol

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Carbamazepine is used in the treatment of epilepsy; it is also prescribed for treatment of 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. There is no specific antidote. Multiple-dose activated charcoal and hemodialysis are the main treatment for carbamazepine intoxication. In this paper, we report the case of a 19-year-old woman with excessive dose carbamazepin intoxication and our successful treatment with multiple-dose activated charcoal and hemodialysis.

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Efficacy of hemodialysis and charcoal hemoperfusion in carbamazepine overdose

Cited by 21 publications

References 6 publications

Delayed Elevation in Carbamazepine Concentrations After Overdose

Delayed Elevation in Carbamazepine Concentrations After Overdose

Blood Purification for Intoxications and Drug Overdose

Successful treatment of excessive dose of carbamazepine

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