This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Askenazi, D. J.
Right arrow Articles by Feig, D. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Askenazi, D. J.
Right arrow Articles by Feig, D. I.
Related Collections
Right arrow Therapeutics & Toxicology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?
PEDIATRICS Vol. 113 No. 2 February 2004, pp. 406-409

EXPERIENCE AND REASON

Management of a Severe Carbamazepine Overdose Using Albumin-Enhanced Continuous Venovenous Hemodialysis

David J. Askenazi, MD*, Stuart L. Goldstein, MD*, I-Fen Chang, PharmD{ddagger}, Ewa Elenberg, MD* and Daniel I. Feig, MD, PhD*

* Renal Section
{ddagger} Pharmacy, Department of Pediatrics, Baylor College of Medicine, Houston, Texas

Carbamazepine intoxication is common in the pediatric population. Highly protein-bound, carbamazepine is not removed efficiently through conventional hemodialysis. We describe the use of albumin-enhanced continuous venovenous hemodialysis (CVVHD) in a 10-year-old girl who developed coma and respiratory depression due to an intentional carbamazepine overdose (peak drug level of 44.8 µg/ml; therapeutic range: 8–12 µg/ml). Without intervention, the half-life of drug elimination is 25 to 60 hours in patients who are naive to carbamazepine and 12 to 20 hours in children on chronic carbamazepine therapy. In contrast, with albumin-enhanced CVVHD, we observed a half-life of 7 to 8 hours. The patient recovered rapidly and was discharged from hospital <4 days from the time of ingestion with no complications or neurologic impairment. Because the cost-benefit analysis was also favorable relative to other therapeutic options, albumin-enhanced CVVHD may be the optimal treatment of toxic-level ingestion of carbamazepine.

Key Words: dialysis • CVVHD • CRRT • carbamazepine • overdose

Abbreviations: ICU, intensive care unit • CVVHD, continuous venovenous hemodialysis

Received for publication Jan 30, 2003; Accepted Apr 28, 2003.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
M. D. Churchwell, D. A. Pasko, W. E. Smoyer, and B. A. Mueller
Enhanced clearance of highly protein-bound drugs by albumin-supplemented dialysate during modeled continuous hemodialysis
Nephrol. Dial. Transplant., January 1, 2009; 24(1): 231 - 238.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
Y. Lurie, Y. Bentur, Y. Levy, E. Baum, and N. Krivoy
Limited Efficacy of Gastrointestinal Decontamination in Severe Slow-Release Carbamazepine Overdose
Ann. Pharmacother., September 1, 2007; 41(9): 1539 - 1543.
[Abstract] [Full Text] [PDF]