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Letter to the Editor| Volume 39, ISSUE 5, P655-656, November 2010

A Case of Carbamazepine Intoxication in a Young Boy

Published:February 23, 2009DOI:https://doi.org/10.1016/j.jemermed.2008.10.007
      Carbamazepine, a commonly used anticonvulsant, is generally a safe drug. However, it has at times been associated with cases of severe toxicity and death. Its pharmacological properties include sedation, anticholinergic, antidysrhythmic, muscle relaxant, antidiuretic, and antidepressant effects (
      • Spiller H.A.
      Management of carbamazepine overdose.
      ). Carbamazepine is available in enteral solid and suspension formulations (
      • Cohen H.
      • Howland M.A.
      • Luciano D.J.
      • et al.
      Feasibility and pharmacokinetics of carbamazepine oral loading does.
      ). In contrast to the solid formulation that is known to have slow and unpredictable absorption, therapeutic loading doses of carbamazepine suspension provide quick and predictable absorption in both children and adults (
      • Cohen H.
      • Howland M.A.
      • Luciano D.J.
      • et al.
      Feasibility and pharmacokinetics of carbamazepine oral loading does.
      ). Pharmacokinetic studies have demonstrated rapid absorption of the suspension resulting in peak and therapeutic concentrations within 2 h of ingestion (
      • Cohen H.
      • Howland M.A.
      • Luciano D.J.
      • et al.
      Feasibility and pharmacokinetics of carbamazepine oral loading does.
      ). In this letter, we discuss the case of a young boy who was followed for epilepsy for 2 years and who had a carbamazepine tablet intake equal to 100 mg/kg.
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