Carbamazepine toxicity

(Redirected from Carbamazepine Toxicity)

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)

Differential Diagnosis

Evaluation

  • Levels do not accurately correlate with clinical severity

Management

  • GI decontamination
  • 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

See Also

References

  1. 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.

Authors:

Ross Donaldson