Fesih AKTAR, Hüseyin ÇAKSEN, Mehmet AÇIKGÖZ, Hayrettin TEMEL, Mehmet Selçuk BEKTAŞ, Avni KAYA

Hyponatremic seizure of carbamazepine poisoning

Karbamazepin yaygın kullanılan antikonvülzan ilaçtır ve genellikle güvenli bir ilaç olarak kabul edilmektedir. Ancak bazen ciddi toksik etkilere, hatta ölümlerle de ilişkili olabilir. Ondört aylık kız hasta konvülsiyon geçirme şikayetiyle getirildi. Travma öyküsü olmayan hastanın fizik muayenesinde genel durumu orta, bilinç letarjikti. Konvülsiyon için bir risk faktörü olmayan hastada mev- cut durumun bir intoksikasyona bağlı olabileceği düşünüldü. Hastamızın annesinin epilepsi hastası olduğu ve Karbazepin kullandığı öğrenildi. Karbazepin ciddi şekilde hiponatremi yapabilir. Çocuklarda açıklanamayan intoksikasyon durumlarında ebeveynlerin kullandığı ilaçlar sorgulanmalıdır.

Karbamazepin intoksikasyonunda hiponatremik konvülziyon

Carbamazepine is a commonly used anticonvulsant and is generally considered to be a safe drug. However, it may sometimes be responsible for some serious toxic effects and even deaths. A 14 month-old girl patient was hospitalized because of convulsion. General condition of this patient without a history of trauma was moderate and her consciousness was lethargic. The patient without other risk factors and a history suggestive of intoxication was admitted to hospital for observation of the clauses of seizure. The patient's mother was epileptic and had a history of using carbamazepine. Carbamazepine can seriously induce hypo- natremia. At children's cases with evidence of poisoning but not be shown, drugs used by parents should be investigated.

PDF

___

1. Spiller HA. Management of carbamazepine overdose. Pediatr Emerg Care 2001;17:452-6.
2.Perez A., Wiley JF. Pediatric Carbamazepine Suspension Overdose-Clinical Manifestations and Toxicokinetics. Ped Emerg Care 2005:21;252-4.
3.Hojer J, Malmlund HO, Berg A. Clinical features in 28 con- secutive cases of laboratory confirmed massive poisoning with carbamazepine alone. J Toxicol Clin Toxicol 1993; 31: 449-58.
4.Zarate CA, Tohen M. Carbamazepine. Sadock BJ and Sadock VA (eds) Kaplan and Sadocks Comprehensive Textbook of Psychiatry. 7th. ed., volume 2. Lippincott Williams and Wilkins, Philadelphia, USA, 2000 p.2282-8.
5.Macnab AJ, Birch P, Maccready J. Carbamazepine poison- ing in children. Pediatr Emerg Care 1993;9:195-8.
6.Yassa R, Iskandar H, Nastase C, Camille Y. Carbamazepine and hyponatremia in patients with affective disorder. Am J Psychiatry 1988;145:339-42.
7.Bertilsson L, Tomson T. Clinical pharmacokinetics and pharmacological effects of carbamazepine and carbam- azepine-10,11-epoxide. An update. Clin Pharmacokinet 1986;11:177-8.