Carbamazepine toxicity: Difference between revisions
m (Rossdonaldson1 moved page Carbamazepine Toxicity to Carbamazepine toxicity) |
|||
| Line 4: | Line 4: | ||
==Clinical Features== | ==Clinical Features== | ||
''May be delayed and follow crescendo-decrescendo course (due to delayed GI motility)'' | |||
*Neurologic | |||
* | **[[Ataxia ]] | ||
**Ataxia | |||
**Nystagmus | **Nystagmus | ||
**Seizures | **[[Seizures]] | ||
**Coma | **[[Coma ]] | ||
*[[Anticholinergic Toxicity]] | *[[Anticholinergic Toxicity]] | ||
* | *Cardiovascular | ||
**Dysrhythmias are rare but may occur | **Dysrhythmias are rare but may occur | ||
**[[Wide QRS]] | **[[Wide QRS]] | ||
Revision as of 02:46, 15 August 2016
Background
- Has anticholinergic and antiepileptic effects
- Therapeutic concentration: 4-12 mg/L
Clinical Features
May be delayed and follow crescendo-decrescendo course (due to delayed GI motility)
- Neurologic
- Anticholinergic Toxicity
- Cardiovascular
- Dysrhythmias are rare but may occur
- Wide QRS
- QT Prolongation
Evaluation
- Levels do not accurately correlate with clinical severity
Management
- GI decontamination
- Activated Charcoal (if presents within 1hr of ingestion)
- Consider Multidose activated charcoal
- Dialysis for severe cases. Indications: [1]
- Intractable seizures or life threatening dysrhythmia (level 1D recommendation)
- Respiratory depression requiring mechanical ventilation or prolonged coma (level 2D suggestion)
- Significant toxicity or rising/persistent carbamazepine level despite activated charcoal and supportive care (level 2D suggestion)
Disposition
- Consider discharge for patient with decreasing levels (measured few hrs apart) and is asymptomatic
References
- ↑ Ghannoum M, Yates C, Galvao TF et al. Extracorporeal treatment for carbamazepine poisoning: Systematic review and recommendations from the EXTRIP workgroup. Clin Tox 2016. 52(10):993-1004.