Mise Stjepan, Jukić Ivana, Tonkić Ante, Titlić Marina, Mise Sandro
Clinical Hospital Split, Split, Croatia.
Arh Hig Rada Toksikol. 2005 Dec;56(4):333-8.
Serious complications after carbamazepine poisoning, such as coma, seizures, respiratory failure, cardiac conduction abnormalities, and death are more likely with serum levels greater than 170 micromol L(-1). We report a case of a single massive carbamazepine overdose in a 19-year-old male, following attempted suicide, without prior history of seizure disorder. On admission, three hours after ingestion, serum carbamazepine concentration was 179 micromol L(-1) and Glasgow Coma Scale scored 6. The patient was intubated and treated with multiple doses of activated charcoal for 48 hours. Twelve hours after ingestion, two repeated generalised myoclonic seizures were noted when serum carbamazepine levels peaked at 181 micromol L(-1), and were successfully treated with diazepam. Carbamazepine serum level fell within the therapeutic range 63 hours after ingestion and the patient was discharged without any long-term sequelae. As there is no antidote for carbamazepine poisoning, supportive treatment remains the only, but usually potent option.
卡马西平中毒后出现严重并发症，如昏迷、癫痫发作、呼吸衰竭、心脏传导异常及死亡，血清浓度大于170微摩尔/升时更易发生。我们报告一例19岁男性单次大量过量服用卡马西平的病例，该患者自杀未遂，既往无癫痫病史。入院时，服药后3小时，血清卡马西平浓度为179微摩尔/升，格拉斯哥昏迷评分为6分。患者行气管插管，并多次服用活性炭治疗48小时。服药后12小时，血清卡马西平水平峰值达181微摩尔/升时，出现两次反复全身性肌阵挛发作，用地西泮成功治疗。服药后63小时，卡马西平血清水平降至治疗范围内，患者出院，无任何长期后遗症。由于卡马西平中毒没有解毒剂，支持治疗仍是唯一但通常有效的选择。
