de Groot G, van Heijst A N, Maes R A
J Toxicol Clin Toxicol. 1984;22(4):349-62. doi: 10.3109/15563658408992566.
Charcoal hemoperfusion is effective in the treatment of acute carbamazepine (CBZ) poisoning, its efficacy depending on the metabolic capacity of the patient involved. This was assessed in two cases of CBZ poisoning in which CBZ and its metabolite carbamazepine-10,11-epoxide (CBZO) were monitored. One patient had not been treated with CBZ or other enzyme-inducing drugs before the overdose ingestion. The CBZO/CBZ plasma concentration ratio of this patient was 0.15 +/- 0.01 (mean +/- s.d.), indicating a normal metabolic capacity. The average clearance values obtained with the Haemocol were 85 ml/min for CBZ and 81 ml/min for CBZO. The other patient had been on long-term treatment with anticonvulsive drugs before. The CBZO/CBZ ratio was 1.58 +/- 0.16, indicating a high metabolic capacity and, consequently, a high intrinsic clearance. The average clearances obtained with the Adsorba 300 C were 129 ml/min for CBZ and 133 ml/min for CBZO. Saturation of a charcoal column can occur during a four hours treatment, in particular if the plasma CBZO concentration is high. CBZ and CBZO were also monitored in erythrocytes. The erythrocyte/plasma concentration ratios of CBZ were 0.90 +/- 0.11 (mean +/- s.d.) and 1.36 +/- 0.10. CBZO was 30-40 per cent more concentrated in erythrocytes than was CBZ. The erythrocyte/plasma concentration ratios of CBZO were 1.36 +/- 0.10 and 1.80 +/- 0.23.
血液灌流在急性卡马西平（CBZ）中毒治疗中有效，其疗效取决于相关患者的代谢能力。在两例CBZ中毒病例中对此进行了评估，监测了其中的CBZ及其代谢产物卡马西平-10,11-环氧化物（CBZO）。一名患者在过量服药前未接受过CBZ或其他酶诱导药物治疗。该患者的CBZO/CBZ血浆浓度比为0.15±0.01（均值±标准差），表明代谢能力正常。使用血液灌流器获得的平均清除率值，CBZ为85毫升/分钟，CBZO为81毫升/分钟。另一名患者此前一直在接受抗惊厥药物的长期治疗。CBZO/CBZ比值为1.58±0.16，表明代谢能力高，因此固有清除率也高。使用吸附树脂300C获得的平均清除率，CBZ为129毫升/分钟，CBZO为133毫升/分钟。在四小时的治疗过程中，活性炭柱可能会饱和，尤其是当血浆CBZO浓度较高时。还对红细胞中的CBZ和CBZO进行了监测。CBZ的红细胞/血浆浓度比分别为0.90±0.11（均值±标准差）和1.36±0.10。CBZO在红细胞中的浓度比CBZ高30% - 40%。CBZO的红细胞/血浆浓度比分别为1.36±0.10和1.80±0.23。
