From unknown poisoning to carbamazepine poisoning
Journal
Emergency Care Journal
Date Issued
2023-06
Author(s)
Andon Chibishev
Niko Bekarovski
Biljana Ivanova
Kiril Naumoski
Abstract
In the 2020 annual report of the American Association of
Poison Control Centers, 2562 toxic exposures to carbamazepine
have been reported, 908 resulted in hospitalization, and among
these about 5-6% were life-threatening or resulted in significant
disability. A 15-year-old female patient was brought under suspicion of alcohol poisoning. The result of alcoholemia was
11.0 mg/dL and the toxicological screening for THC, opiates,
methadone, tramadol, amphetamine, MDMA, cocaine, benzodiazepines, buprenorphine was negative. At admission she was
comatose (GCS=6), with metabolic acidosis, hypotension, rare
short-term partial seizures, isochoric and later dilated pupils, body
temperature was 36.4°C, with oxygen saturation from 89 up to
93%. Toxicological analysis were immediately extended. After
three hours of admission, a result was obtained where the plasma
concentration for carbamazepine was 167mmol/L. The patient was
quickly prepared for hemodialysis which was performed for four
hours. After 8 hours of admission the patient woke up with stable
vital parameters.
Poison Control Centers, 2562 toxic exposures to carbamazepine
have been reported, 908 resulted in hospitalization, and among
these about 5-6% were life-threatening or resulted in significant
disability. A 15-year-old female patient was brought under suspicion of alcohol poisoning. The result of alcoholemia was
11.0 mg/dL and the toxicological screening for THC, opiates,
methadone, tramadol, amphetamine, MDMA, cocaine, benzodiazepines, buprenorphine was negative. At admission she was
comatose (GCS=6), with metabolic acidosis, hypotension, rare
short-term partial seizures, isochoric and later dilated pupils, body
temperature was 36.4°C, with oxygen saturation from 89 up to
93%. Toxicological analysis were immediately extended. After
three hours of admission, a result was obtained where the plasma
concentration for carbamazepine was 167mmol/L. The patient was
quickly prepared for hemodialysis which was performed for four
hours. After 8 hours of admission the patient woke up with stable
vital parameters.
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