Carbamazepine and the active epoxide metabolite are effectively cleared by hemodialysis followed by continuous venovenous hemodialysis in an acute overdose

Hemodialysis International

Volumn 15, Issue 3, 2011, Pages 412-415

  Harder, Jennifer L ^a   Heung, Michael ^a   Vilay, A Mary ^b   Mueller, Bruce A ^c   Segal, Jonathan H ^a  

^a UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF NEW MEXICO   (United States)

^c UNIVERSITY OF MICHIGAN   (United States)

Author keywords

Carbamazepine; CVVHD; Hemodialysis; Overdose; Pharmacokinetics

Indexed keywords

ACTIVATED CARBON; BICARBONATE; CALCIUM; CARBAMAZEPINE; CREATININE; EPOXIDE; HYPERTENSIVE FACTOR;

ADULT; ARTICLE; BICARBONATE BLOOD LEVEL; BLOOD FLOW VELOCITY; CALCIUM BLOOD LEVEL; CASE REPORT; CONTINUOUS HEMODIALYSIS; CREATININE BLOOD LEVEL; DRUG CLEARANCE; DRUG HALF LIFE; DRUG INTOXICATION; FEMALE; GLASGOW COMA SCALE; HEMODIALYSIS; HOSPITAL DISCHARGE; HUMAN; HYPOREFLEXIA; HYPOTENSION; INTESTINE SOUND; MUSCLE TONE; NASOGASTRIC TUBE; SODIUM BLOOD LEVEL; SUICIDE ATTEMPT; ULTRAFILTRATION;

ADULT; ANALGESICS, NON-NARCOTIC; CARBAMAZEPINE; HALF-LIFE; HUMANS; MALE; OVERDOSE; RENAL DIALYSIS; TIME FACTORS;

EID: 79959979514     PISSN: 14927535     EISSN: 15424758     Source Type: Journal    
DOI: 10.1111/j.1542-4758.2011.00563.x     Document Type: Article

References (20)

1. Schmidt S, Schmitz-Buhl M. Signs and symptoms of carbamazepine overdose. J Neurol. 1995; 242:169-173.
2. Graudins A, Peden G, Dowsett RP. Massive overdose with controlled-release carbamazepine resulting in delayed peak serum concentrations and life-threatening toxicity. Emerg Med. 2002; 14:89-94.
3. Vree TB, Janssen TJ, Hekster YA, Termond EF, van de Dries AC, Wijnands WJ. Clinical pharmacokinetics of carbamazepine and its epoxy and hydroxy metabolites in humans after an overdose. Ther Drug Monit. 1986; 8:297-304.
4. Askenazi DJ, Goldstein SL, Chang IF, Elenberg E, Feig DI. Management of a severe carbamazepine overdose using albumin-enhanced continuous venovenous hemodialysis. Pediatrics. 2004; 113:406-409.
5. Bek K, Kocak S, Ozkaya O, Yilmaz Y, Aydin OF, Tasdoven CS. Carbamazepine poisoning managed with haemodialysis and haemoperfusion in three adolescents. Nephrology. 2007; 12:33-35.
6. Holubek WJ, Hoffman RS, Goldfarb DS, Nelson LS. Use of hemodialysis and hemoperfusion in poisoned patients. Kidney Int. 2008; 74:1327-1334.
7. Low CL, Haqqie SS, Desai R, Bailie GR. Treatment of acute carbamazepine poisoning by hemoperfusion. Am J Emerg Med. 1996; 14:540-541.
8. Kielstein JT, Schwarz A, Arnavaz A, Sehlberg O, Emrich HM, Fliser D. High-flux hemodialysis - an effective alternative to hemoperfusion in the treatment of carbamazepine intoxication. Clin Nephrol. 2002; 57:484-486.
9. Tapolyai M, Campbell M, Dailey K, Udvari-Nagy S. Hemodialysis is as effective as hemoperfusion for drug removal in carbamazepine poisoning. Nephron. 2002; 90:213-215.
10. Swartz R, Pasko D, O'Toole J, Starmann B. Improving the delivery of continuous renal replacement therapy using regional citrate anticoagulation. Clin Nephrol. 2004; 61:134-143.
11. Eichelbaum M, Ekbom K, Bertilsson L, Ringberger VA, Rane A. Plasma kinetics of carbamazepine and its epoxide metabolite in man after single and multiple doses. Eur J Clin Pharmacol. 1975; 8:337-341.
12. Gidal BE, Spencer NW, Maly MM, Pitterle ME. Evaluation of carbamazepine and carbamazepine-epoxide protein binding in patients undergoing epilepsy surgery. Epilepsia. 1996; 37:381-385.
13. Hooper WD, King AR, Patterson M, Dickinson RG, Eadie MJ. Simultaneous plasma carbamazepine and carbamazepine-epoxide concentrations in pharmacokinetic and bioavailability studies. Ther Drug Monit. 1985; 7:36-40.
14. Potter JM, Donnelly A. Carbamazepine-10, 11-epoxide in therapeutic drug monitoring. Ther Drug Monit. 1998; 20:652-657.
15. Rambeck B, Salke-Treumann A, May T, Boenigk HE. Valproic acid-induced carbamazepine-10, 11-epoxide toxicity in children and adolescents. Eur Neurol. 1990; 30:79-83.
16. So EL, Ruggles KH, Cascino GD, Ahmann PA, Weatherford KW. Seizure exacerbation and status epilepticus related to carbamazepine-10, 11-epoxide. Ann Neurol. 1994; 35:743-746.
17. Cotter LM, Eadie MJ, Hooper WD, Lander CM, Smith GA, Tyrer JH. The pharmacokinetics of carbamazepine. Eur J Clin Pharmacol. 1977; 12:451-456.
18. Konsil J, Dechasathian S, Mason DH Jr, Stevens RE. Reanalysis of carbamazepine and carbamazepine-epoxide pharmacokinetics after multiple dosing of extended release formulation. J Pharm Pharm Sci. 2002; 5:169-175.
19. Churchwell MD, Pasko DA, Smoyer WE, Mueller BA. Enhanced clearance of highly protein-bound drugs by albumin-supplemented dialysate during modeled continuous hemodialysis. Nephrol Dial Transplant. 2009; 24:231-238.
20. Dhondt A, Verstraete A, Vandewoude K, et al. Efficiency of the Genius batch hemodialysis system with low serum solute concentrations: The case of lithium intoxication therapy. Am J Kidney Dis. 2005; 46:e95-e99.