الفهرس 
Historical ReviewOnly 14 pages are availabe for public view
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Abstract
Abstract
Carbamazepine (CBZ) is a commonly used antiepileptic drug and also prescribed for treatment of trigeminal neuralgia. The common toxic effects after acute carbamazepine ingestion include neurological abnormalities as ataxia, seizures, nystagmus and coma and cardiovascular findings as sinus tachycardia, prolonged PR and QRS intervals, ventricular tachycardia or fibrillation, and hypotension.
Aim of the work: The aim of this study was to find out the frequency of some neurological and cardiovascular effects in patients admitted to poison control center, Ain Shams University, acutely intoxicated by carbamazepine and to assess the possible role of carbamazepine level & Glasgow Coma Scale (GCS) as predictors for ECG changes and outcome.
Material and methods: A prospective study was conducted on all patients of both sexes with history of acute carbamazepine overdose, admitted to Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) from July 2015 to December 2016. The total number of acutely intoxicated carbamazepine cases in this study was 200 patients, they were divided into: group I (adult patients): they were 108 patients subdivided into: group Ia: Included non-complicated patients and consisted of 80 patients and group Ib: Included complicated patients and consisted of 28 patients. group II (pediatric patients): they were 92 patients subdivided into: group IIa: Included non-complicated patients and consisted of 68 patients and group IIb: Included complicated patients and consisted of 24 patients. Results: In adult patients:- The best cut off point for peak serum carbamazepine level as a predictor of outcome in adult patients was >35 mg/L with a sensitivity of 71.4%, a specificity of 95%. The best cut point for GCS as a predictor of complications in adult patients acutely intoxicated with carbamazepine was ≤ 8 with a sensitivity of 100%, a specificity of 45%. In pediatric patients The best cut off point for peak serum carbamazepine level as a predictor of outcome in pediatric patients was > 26mg\L with a sensitivity of 100%, a specificity of 52.9%. The best cut point for GCS as a predictor of outcome in pediatric patients acutely intoxicated with carbamazepine was ≤ 5 with a sensitivity of 33.3%, a specificity of 94.1%.Conclusion: Peak serum carbamazepine level and Glasgow coma scale (GCS) might be useful in predicting outcome in both adult and pediatric patients. It appears that pediatric patients are at risk of serious morbidity from CBZ overdose at lower serum carbamazepine concentrations than adult patients.
Keywords: Carbamazepine, Glasgow Coma Scale, serum level, complication