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Pediatric carbamazepine suspension overdose-clinical manifestations and toxicokinetics

Alberto Perez1, James F Wiley

  • 1Division of Medical Toxicology, Department of Emergency Medicine/Traumatology, University of Connecticut School of Medicine, Hartford, CT, USA. aaperez@harthosp.org

Pediatric Emergency Care
|April 13, 2005
PubMed

Insights

Carbamazepine suspension overdose in toddlers caused severe central nervous system depression, requiring intubation in one case. Prompt medical attention is crucial due to rapid absorption, with both children recovering fully within 24 hours.

Area of Science:

  • Pediatric Toxicology
  • Clinical Pharmacology

Background:

  • Carbamazepine is a commonly prescribed anticonvulsant and mood-stabilizing medication.
  • Accidental pediatric ingestions of liquid formulations can lead to significant toxicity.

Observation:

  • Two toddlers ingested carbamazepine suspension, presenting with central nervous system depression.
  • One child required intubation due to the severity of the depression.
  • Clinical course was dominated by coma, without seizures or dysrhythmias.

Findings:

  • Initial carbamazepine concentrations were high (36.6 and 22.7 mg/L).
  • Observed elimination rates indicated zero-order kinetics (1.4 and 0.75 mg/L/hr).
  • This study provides the first toxicokinetic data for carbamazepine suspension overdose in children.

Implications:

  • Rapid oral absorption of carbamazepine suspension necessitates immediate medical evaluation after pediatric exposure.
  • Understanding toxicokinetic parameters aids in managing carbamazepine overdose in pediatric patients.
  • Early intervention can lead to complete recovery without long-term sequelae.

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