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A Child with Coma, Hypotension, Respiratory Depression and Cardiac Conduction Disturbance - Carbamazepine Poisoning


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1 Department of Paediatrics, JSS Medical College, JSS University, Mysore, India
     

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Previously healthy child presenting with coma, hypotension and respiratory depression is challenge to the treating clinician. The wide availability of anticonvulsants increases the risk of overdose, may be intentional or accidental. Adequate history taking is very important to clinch the diagnosis. The clinical spectrum of carbamazepine poisoning may range from drowsiness to profound coma with respiratory failure. Cardiotoxicity is rare, presents primarily as conduction disturbances. Here with we report a 14 year old boy who presented with coma, respiratory depression, hypotension and cardiac involvement. The diagnosis of carbamazepine toxicity was revealed only after adequate history taking and toxicology screening.

Keywords

Carbamazepine, Coma, Conduction Disturbance, Hypotension, Screening.
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  • Spiller HA. Management of carbamazepine overdose. Pediatr Emerg Care. 2001; 17:452-456.
  • Pediatric Carbamazepine Toxicity Treatment & Management. Author: Muhammad Waseem. Chief Editor: Timothy E Corden.Updated: March 10,2016. http://emedicine.medscape.com/article/1011240-treatment.
  • Lifshitz M, Gavrilov V, Sofer S.Signs and symptoms of carbamazepine overdose in young children. Pediatr Emerg Care. 2000;16:26-27.
  • Gheshlaghi F, Yaraghi A, Soh EH, Ghoreishi A. Relationship of Cardiovascular Complications with Level of Consciousness in Patients with Acute Carbamazepine Intoxication. Med Arh. 2012; 66: 9-11.
  • Bridge TA, Norton RL, Robertson WO.Pediatric carbamazepine overdoses. Pediatr Emerg Care. 1994;10:260-263.
  • Schmidt S, Schmitz-Buhl M. Signs and symptoms of carbamazepine overdose. J Neurol 1995; 242:169-173.
  • Spiller HA, Krenzelok EP. Carbamazepine overdose: serum concentration less predictive in children. J Toxicol Clin Toxicol. 1993;31:459-460
  • Ciszowski K, Szpak D, Jenner B. The influence of carbamazepine plasma level on blood pressure and some ECG parameters in patients with acute intoxication. Przegl Lek.2007; 64: 248-251
  • Apfelbaum J D, Caravati E M, Kerns W P et al. Cardiovascular effects of carbamazepine toxicity. Ann Emerg Med. 1995; 25: 631-635.
  • Patel VH, Schindlbeck MA, Bryant SM. Delayed elevation in carbamazepine concentrations after overdose: a retrospective poison center study. Am J Ther. 2013; 20:602-606.

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  • A Child with Coma, Hypotension, Respiratory Depression and Cardiac Conduction Disturbance - Carbamazepine Poisoning

Abstract Views: 469  |  PDF Views: 4

Authors

K. Jagadish Kumar
Department of Paediatrics, JSS Medical College, JSS University, Mysore, India
Naresh Yerraguntla
Department of Paediatrics, JSS Medical College, JSS University, Mysore, India
Allampally Rakesh
Department of Paediatrics, JSS Medical College, JSS University, Mysore, India
Nikhitha Shajahan
Department of Paediatrics, JSS Medical College, JSS University, Mysore, India

Abstract


Previously healthy child presenting with coma, hypotension and respiratory depression is challenge to the treating clinician. The wide availability of anticonvulsants increases the risk of overdose, may be intentional or accidental. Adequate history taking is very important to clinch the diagnosis. The clinical spectrum of carbamazepine poisoning may range from drowsiness to profound coma with respiratory failure. Cardiotoxicity is rare, presents primarily as conduction disturbances. Here with we report a 14 year old boy who presented with coma, respiratory depression, hypotension and cardiac involvement. The diagnosis of carbamazepine toxicity was revealed only after adequate history taking and toxicology screening.

Keywords


Carbamazepine, Coma, Conduction Disturbance, Hypotension, Screening.

References





DOI: https://doi.org/10.22506/ti%2F2017%2Fv24%2Fi3%2F166496