Montoya-Cabrera M A, Sauceda-García J M, Escalante-Galindo P, Flores-Alvarez E, Ruiz-Gómez A
Departamento de Admisión Continua y Toxicologia, Hospital de Pediatria, Centro Mèdico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mèxico, D.F.
Arch Med Res. 1996 Winter;27(4):485-9.
The aim of the study was to evaluate continuous administration of multiple-dose activated charcoal (MDAC) in enhancing elimination of carbamazepine (CBZ) in eight consecutive adolescent suicide attempters. Diluted charcoal was administered through a nasogastric tube at a dose of 1 g/kg every 4 h, and a saline cathartic at the same dosage was administered every 12 h. Plasma CBZ concentrations were measured at 0.0, 12, 24 and 36 h by means of a modified EMIT technique. As a measure of CBZ disappearance, half life of elimination (t1/2 beta) and exogenous total body clearance (CLB) were calculated. Clinical improvement occurred after 12 to 24 h, except in one patient who was the most severely intoxicated and who required advanced life-support therapy. Pharmacokinetic data reported a mean t1/2 beta of 9.5 h, shorter than the reference value of 18-54 h (p < 0.05), and a mean CLB of 103.13 ml/ min/kg, higher than the reference of 75.01 ml/min/ kg (p < 0.05). Initial mean CBZ levels of 27.9 decreased to 0.82 microgram/ml (97% of elimination, p < 0.05). MDAC was free from adverse side effects. In conclusion, MDAC is an effective procedure in enhancing CBZ elimination in overdosed patients as well as being relatively free from serious side effects, widely available, inexpensive and non-invasive.
本研究的目的是评估连续给予多剂量活性炭（MDAC）对8例连续的青少年自杀未遂者中卡马西平（CBZ）清除率的影响。将稀释后的活性炭通过鼻胃管以每4小时1 g/kg的剂量给药，同时每12小时给予相同剂量的生理盐水泻药。采用改良的酶放大免疫测定技术（EMIT）在0.0、12、24和36小时测量血浆CBZ浓度。作为CBZ消失的指标，计算消除半衰期（t1/2β）和外源性全身清除率（CLB）。除1例中毒最严重且需要高级生命支持治疗的患者外，其余患者在12至24小时后临床症状改善。药代动力学数据显示，平均t1/2β为9.5小时，短于参考值18 - 54小时（p < 0.05），平均CLB为103.13 ml/min/kg，高于参考值75.01 ml/min/kg（p < 0.05）。初始平均CBZ水平27.9降至0.82微克/毫升（清除率97%，p < 0.05）。MDAC无不良副作用。总之，MDAC是一种有效的方法，可提高过量服药患者的CBZ清除率，且相对无严重副作用，广泛可用，价格低廉且非侵入性。
