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Takia L, Kc S, Randhawa M, Angurana SK, Nallasamy K, Bansal A, Jayashree M. Clinical Features, Intensive Care Needs, and Outcome of Carbamazepine Poisoning in Children. Indian J Pediatr 2022; 89:1022-1024. [PMID: 35277811 DOI: 10.1007/s12098-022-04155-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/24/2021] [Indexed: 11/26/2022]
Abstract
Carbamazepine is commonly used antiseizure medication with a narrow therapeutic range. The data on carbamazepine poisoning in children from India is limited. In this retrospective study, the authors reported 10 children with carbamazepine poisoning admitted to pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India over a period of 8 y (2013 to 2020). The median age was 5.5 (4.3-6) y and 60% cases were males. All had accidental ingestion and the dose ingested was 96 (80-103) mg/kg. The common clinical features were drowsiness (100%), tachycardia (80%), vomiting (60%), seizures (60%), respiratory failure (60%), and dystonia (50%). At admission, 60% children had coma. The treatment included gastric lavage (70%), single-dose-activated charcoal (60%), multidose-activated charcoal (30%), mechanical ventilation (60%), and dialysis (20%). The duration of PICU and hospital stay was 36 (22-45) h and 48 (48-60) h, respectively. There was no mortality.
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Affiliation(s)
- Lalit Takia
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Sudeep Kc
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Manjinder Randhawa
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Suresh Kumar Angurana
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Karthi Nallasamy
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Arun Bansal
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Muralidharan Jayashree
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatric Center (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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Carbamazepine-, Oxcarbazepine-, Eslicarbazepine-Associated Movement Disorder: A Literature Review. Clin Neuropharmacol 2020; 43:66-80. [PMID: 32384309 DOI: 10.1097/wnf.0000000000000387] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ferranti S, Grande E, Gaggiano C, Grosso S. Antiepileptic drugs: Role in paediatric poisoning. J Paediatr Child Health 2018; 54:475-479. [PMID: 29292550 DOI: 10.1111/jpc.13833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/03/2017] [Accepted: 11/14/2017] [Indexed: 11/29/2022]
Abstract
Intoxications, both accidental and intentional, are common in children and adolescents and often require hospitalisation and intensive treatment. Antiepileptic drugs are a possible cause of poisoning and intoxications because this category of medications has shown a rising trend in recent years. They might be responsible for multi-organ dysfunctions of variable severity, ranging from subtle symptoms to life-threatening complications. No guidelines on the management of these intoxications in the paediatric population are currently available, and treatment is mainly supportive. Activated charcoal administration and extracorporeal circulation techniques for drug removal have been proposed. Facing the complexity of this clinical scenario, it is of utmost importance to maintain a high index of suspicion to guarantee a prompt intervention and ensure the best possible management for the patient.
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Affiliation(s)
- Silvia Ferranti
- Clinical Pediatrics, Pediatric Neurology Center, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Elisabetta Grande
- Clinical Pediatrics, Pediatric Neurology Center, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Carla Gaggiano
- Clinical Pediatrics, Pediatric Neurology Center, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Salvatore Grosso
- Clinical Pediatrics, Pediatric Neurology Center, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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