Carbamazepine toxicity

Background

• Has anticholinergic and antiepileptic effects
• Therapeutic concentration: 4-12

Clinical Features

• May be delayed and follow crescendo-decrescendo course (due to delayed GI motility)
• CNS
  • Ataxia
  • Nystagmus
  • Coma
• Anticholinergic Toxicity
• CV
  • Dysrhythmias are rare but may occur
  • Wide QRS
  • QT Prolongation

Diagnosis

• Levels do not accurately correlate w/ clinical severity

Treatment

• GI detox
  • Activated Charcoal (if presents w/in 1hr of ingestion)
• Dialysis is effective (if needed)

Disposition

• Consider d/c for pt with decreasing levels (measured few hrs apart) and is asymptomatic

Source

• Tintinalli