Carbamazepine Toxicity in Emergency Medicine Follow-up
- Author: Nidhi Kapoor, MD; Chief Editor: Asim Tarabar, MD more...
Further Inpatient Care
- Monitor carbamazepine plasma levels to make sure that they are decreasing and correlating with the clinical picture.
- Admit the patient to the monitored setting with cardiac telemetry.
Transfer
Transfer the patient if appropriate monitoring facilities or critical care areas are not available.
Deterrence/Prevention
Education and communication between the primary care physician and the patient is important for prevention of carbamazepine overdose.
Complications
Complications of carbamazepine toxicity may include the following:
- Coma
- Elevated liver function test results
- Pulmonary edema
- Pancytopenia
- Anuria
Prognosis
- The patient may experience altered levels of consciousness for several days following acute overdose.
- The patient's clinical examinations should improve as the plasma levels of the drug fall.
Patient Education
- Carefully explain the proper method of taking anticonvulsants to avoid adverse reactions.
- Educate to keep all medications and poisons in a locked cabinet or on high shelves to prevent pediatric accidental ingestions.
- Instruct patients and parents to ensure that suspensions of carbamazepine should be shaken vigorously before administration. Otherwise, the drug settles in its container and early doses will contain less carbamazepine and subsequent underdosing will occur; later doses may contain more drug and lead to toxicity.
- For excellent patient education resources, visit eMedicine's Drug Overdose Center and Poisoning - First Aid and Emergency Center. Also, see eMedicine's patient education articles Poisoning, Drug Overdose, Activated Charcoal, and Poison Proofing Your Home.
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