Frequency and Distribution of Cardiovascular Changes as well as Consciousness Alterations in Patients with Carbamazepine Toxicity

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Due to significant effects of carbamazepine toxicity on the cardiovascular system and the present contraversy about the frequency of cardiovascular manifestations in such patients, this study was designed to evaluate this issue more throughly.Methods: In a cross-sectional study, patients with carbamazepine poisoning referred to Nour Hospital, Isfahan, were recruited using convinience sampling method. ECG parameters (QRS complex, QT interval, and PR interval), pulse rate, and blood pressure changes, as well as consciousness alterations, were measured in patients on admission and 12 and 24 hours later.Finding: Among 77 patients 49 (63.6%) were women. There was no significant relationship between QT interval and QRS complex changes and pulse rate alteration and carbamazepine toxicity; but there was meaningful association between pulse rate, blood pressure (systolic and diastolic), and PR interval changes. Furtheremore, there was significant decreasing relationship between loss of consciousness (coma) and blood pressure [systolic and mean arterial blood pressure (MABP)], pulse rate, QRS complex changes at 12 hours after admission. QRS complex had much more width in these patients in comparison with others. There was no correlation between loss of consciousness and diastolic blood pressure, QT interval and PR interval on admisson and 12 hours and 24 hours later.Conclusion: Regarding the founded relation between level of consciousness and changes at 12 hours after admission, evaluation of patients about vital sign and ECG monitoring, specialy in lower level of consciousness, should be considered; it will lead to prevent unexpected complication, mortality and to reduce the length of hospitalisation.  

Keywords

References

  1. Oner S, Yenilmez C, Ayranci U, Gunay Y, Oz-damar K. Sexual differences in the completed suicides in Turkey. European Psychiatry 2007; 22(4): 223-8.
  2. Auerbach PS, Norris RL. Poisoning, Drug overdose, and Envenomation. In: Fauci AS, Braunwald E , Kasper DS, Hauser Sl, Longo Dl, Jameson Jl, et al. Harrison’s principle of internal medicine: 17th ed. New York: McGraw-Hill; 2008. p. 2741-2.
  3. Repetto MR. Epidemiology of Poisoning Due to Pharmaceutical Products, Poison Control Center, Seville, Spain. Eur J Epidemiol 1997; 13(3): 353-6.
  4. Haddad Lester M. Management of clinical poisoning and drug overdose. 3rd ed. Philadelphia: WB Saunders; 1998. p. 254-6.
  5. Katzong Bertram G. Basic and clinical pharmacology. 8th ed. New York: McGraw-Hill; 2001. p. 148-56.
  6. Schonwald SMD, Ellenhorn MJ. Medical toxi-cology: A Synopsis and Study Guide. 1st ed. Philadelphia: Lippincott William and Wilkins. 2001; p. 305-11.
  7. Doyon S. Anticonvulsants. In: Flomenbaum NE, Goldfrank LE, Hoffman RS, Howland MA, Lewin NA, Nelson LS. Goldfrank’s toxicologic emergencies. 8th edition, New York: McGraw-
  8. Hill; 2006. p. 735-7.
  9. Osborn H. Anticonvulsants. In: Goldfrank LR, Flomenbaum NE, Lewin NA, Weisman RS, Hoffman RS, Howland MA. Goldfrank’s toxicologic emergencies. 5th ed. Norwalk, CT: Appleton & Lange; 1994. p. 594-5.
  10. Seger D. Phenytoin and other anticonvulsants. In: Haddad LM, Winchester JF. Clinical man-agement of poisoning and drug overdose. 2nd ed. Philadelphia: WB Saunders company; 1990. p. 887-90.
  11. Mckinney PE, Birnbaum K. Carbamazepine. In: Ford MD, Delaney KA, Ling LJ, Erickson T. Clinical toxicology. Philadelphia: WB Saunders; 2001. p. 478-83.
  12. Braitberg G. Carbamazepine. In: Brent J, Wal-lace KL, Burkhart KK, Philips SD, Donovan JW. Critical care toxicology. Philadelphia: Elsevier Mosby; 2005. p. 559-64.
  13. Apfelbaum JD, Caravati EM, Kerns WP, Bos-sart PJ, Larsen G. Cardiovascular effects of carbamazepine toxicity. Ann Emerg Med 1995; 25(5): 631-5.
  14. Ciszowski K, Szpak D, Jenner B. The influence of carbamazepine plasma level on blood pressure and some ECG parameters in patients with acute intoxication. Przegl Lek 2007; 64(4-5): 248-51.
Journal of Isfahan Medical School
Volume 28, Issue 117 - Serial Number 117
November and December 2011
Pages 1160-1167

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History

  • Receive Date: 19 March 2011
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

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