Mochizuki Katsunori, Hamano Yujiro, Miyama Hiroshi, Arakawa Kazuki, Kobayashi Takashi, Imamura Hiroshi
Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan.
Acute Med Surg. 2015 Apr 28;3(1):36-38. doi: 10.1002/ams2.117. eCollection 2016 Jan.
We report a case with concurrent ingestion of carbamazepine (CBZ) overdose and grapefruit juice. A 23-year-old man, with a history of epilepsy, was admitted to our emergency department 2 h after ingesting 10 g CBZ with 1 L grapefruit juice. On arrival, the patient's Glasgow Coma Scale score was 9 and he showed signs of restlessness. Grapefruit juice-like gastric fluid, with tablet residue, was observed in his stomach after we inserted a gastric tube. Our initial test detected a blood CBZ level of 41.5 mg/L.
We treated the patient with gastric lavage, activated charcoal, and charcoal hemoperfusion. His blood CBZ level began to decrease after gastrointestinal decontamination, and he was discharged without any sequelae on day 9.
Gastric lavage or aspiration may be considered in cases where drug residue is found in the stomach, especially if materials are involved that might exacerbate the drug's toxicity.
我们报告一例同时摄入过量卡马西平（CBZ）和葡萄柚汁的病例。一名23岁男性，有癫痫病史，在摄入10克卡马西平并饮用1升葡萄柚汁2小时后被送入我院急诊科。入院时，患者格拉斯哥昏迷量表评分为9分，表现出烦躁不安的症状。插入胃管后，在其胃内观察到类似葡萄柚汁的胃液及片剂残渣。我们的初步检测发现其血液中卡马西平水平为41.5毫克/升。
我们对患者进行了洗胃、活性炭治疗及血液灌流。胃肠道去污后其血液中卡马西平水平开始下降，第9天他出院，无任何后遗症。
在胃内发现药物残渣的情况下，尤其是涉及可能加重药物毒性的物质时，可考虑洗胃或抽吸。
