Carbamazepine overdose: symptoms and treatment
Carbamazepine is a drug which is prescribed to patients with epilepsy. It relieves convulsions and relates to the vital medicines. Overdose of carbamazepine occurs in case of violation the scheme of treatment or with improper dosage of the drug. This primarily affects the nervous system and heart.
The action of drugs on the body and to whom it is prescribed
Carbamazepine is prescribed for such pathologies:
- neurological seizures in the mind or without it;
- tonic-clonic seizures;
- manic state with acute exacerbation;
- alcohol cravings;
- trigeminal neuralgia;
- pain with neuropathy of diabetic origin.
Seizures occur as a result of multiple discharges of neurons. The drug interferes with this process, preventing the risk of epileptic seizures. Carbamazepine affects the major nerve channels, increases their conductivity.
Psychotropic effect is due to the oppression of hormones. The drug reduces the frequency of attacks, eliminates depression, anxiety, aggression and irritation in patients with epilepsy. Prevents the development of pain associated with neuralgia.
When withdrawal syndrome reduces nervous excitability and trembling of the hands. Improves coordination of movement, reducing the unsteadiness in the walk.
Of action of carbamazepine:
- anticonvulsants – prevents convulsions;
- neurotropic – affects the Central nervous system;
- psychotropic – affecting the brain's limbic system (regulates the functions of sleep and wakefulness, emotions, memory);
- antipsychotic – eliminates psychotic disorders (hallucinations, illusions, delusions, aggressiveness);
- normotimicescoe – stabilizes the mood of patients with mental disturbances.
- antidiuretic – facilitates urination.
The action of the drug is not depends of food intake. It is absorbed slowly and reaches maximum effect after 12 hours. Matter breaks down in the liver and is excreted by the kidneys.
Signs of an overdose of carbamazepine
The drug directly or through effects on the nervous system affects the function of all internal organs.
Signs of effects of overdose of carbamazepine on the nervous system:
- dizziness, chronic fatigue, headache, drowsiness;
- violation of consistency of the movement of different muscle groups;
- diplopia is a vision disorder in which one visible object is split horizontally, impaired clarity of vision items;
- fast, involuntary and rhythmic contractions of different muscle groups;
- nervous tics – fast repetitive movements of body parts (hands, feet, head) as a result of erroneous commands of the brain;
- frequent oscillatory movements of the eyeballs;
- involuntary cocanie, licking, protruding tongue;
- violation of motion in joints;
- taste disturbance, partial paralysis;
- peripheral neuropathy – damage to nerves that carry impulse from viscera to the brain.
Carbamazepine in high doses, has a destructive effect on the human psyche. Patients enter a state of prolonged depression, experiencing auditory and visual hallucinations. May develop anorexia. Some people are under the influence of the drug is restless, aggressive, increased psychosis and emotional arousal. While they are disoriented.
Symptoms of poisoning by medication on the digestive system:
- dry mouth, thirst;
- nausea, vomiting;
- constipation or diarrhea;
- salivation, inflammation of the oral mucosa;
- pancreatitis – inflammation of the pancreas.
The average severity of poisoning develops liver failure, jaundice, hepatitis granulomatous. In severe cases, the victim observed a high fever, hypersensitivity to external stimuli. The skin develops various dermatitisa reactions: urticaria, exfoliative dermatitis, severe itching, systemic lupus erythematosus, vasculitis, erythroderma, nodular erythema. You may experience changes in skin pigmentation. Increased sweating, hair falls out.
There is a disorder of the heart and blood vessels. Main manifestations:
- disturbed conduction within the heart;
- blood pressure can go down as well as rise;
- slow heartbeat;
- the crashing rhythms of the heart;
- congestive heart failure;
- collapse, fainting;
- blood clots in the veins;
- thromboembolism – obstruction of venous blood clots.
Reaction of the endocrine system overdose carbamazepine is manifested in the form of serious metabolic disorders. There is a delay of the withdrawal of fluid from the body. The result is edema of the extremities, increased body weight. Happens water intoxication, which is characterized by vomiting, headaches, disorientation. Disturbed hormonal balance in the body and bone metabolism that leads to its brittleness and friability.
Since carbamazepine is excreted by the kidneys, the excess content in the body directly affect their work. The kidneys are inflamed, develops failure. This is manifested by such symptoms:
- the delay in generationof urine, but frequent urination;
- the blood, nitrogen and protein in the urine;
- sexual dysfunction,
Men have disturbed the process of spermatogenesis (formation of sperm).
The excess of carbamazepine in the body affects the lungs, there is shortness of breath, difficulty breathing, in severe cases, pneumonia.
The senses also react to large doses of the drug. Intraocular pressure increases, the lens becomes cloudy, inflamed mucous eye. Disturbed sensitivity of taste receptors, auditory sensitivity.
In rare cases, it develops aseptic meningitis – inflammation of meninges.
First aid and treatment overdose carbamazepine
Specific antidote to drug drug no. When the poisoning is necessary to refer to the narrow specialist, as carbamazepine is a potent substance, the consequences of poisoning can be irreversible, for the nervous system and psyche.
First aid is repeated gastric lavage, to clean wash water. Then give the adsorbents for oral administration, they bind the particles of medication and do not let them be absorbed into the bloodstream. In the intestine they are also not absorbed and excreted drug in the feces from the body. Prescribe laxatives for bowel cleansing from the residue of the drug.
Event first aid may hide the symptoms of poisoning for 2-3 days. And after a noticeable improvement in sharply growing signs of intoxication.
Then symptomatic treatment:
- with high blood pressure – antihypertensive drugs;
- upon accession of infection – antibiotics;
- to reduce the high temperature – antipyretic;
- to restore the work of the kidneys – detoxification and infusion therapy;
- for the relief of epileptic seizures – benzodiazepine;
- to support the liver – a hepatic;
- the restoration of a hormonal background.
Overdose carbamazepine completely ineffective activities such as hemodialysis (artificial kidney), forced diuresis (a single administration of intravenous fluid volume of 6-8 liters). In this case, use only hemosorption on coal sorbents (cleansing of the blood components using a special apparatus).
The treatment is carried out under the continuous control of cardiac activity, the patient regularly do the ECG.
In the case of shock, lack of consciousness, coma, carried out resuscitation – mechanical ventilation, cardioversion.
What you need to know to avoid overdose
With caution carbamazepine you want to assign and accept people with disorders of the organs of hematopoiesis, namely the bone marrow. Overdose will contribute to the violation of formula of blood:
- increase the number of white blood cells;
- reduced platelets, eosinophile;
- deficiency of folic acid, which is the basis for the functioning of the nervous system;
- the development of anaemia of different types.
These changes negatively affect the immune system, reduce the body's resistance, with a slight overdose contribute to the accession of secondary infection. This worsens the General condition of the victim, increases the recovery time.
Lest poisoning, the dosage should be small, the increase is slow and gradual. In rare cases it is possible to dramatically increase the dose, but it is necessary to consider all possible risks of such appointment.
Excess accumulation of the drug in the blood helps the medicinal plant St. John's wort. Therefore, during the treatment its use should be abandoned.
When administered simultaneously with anti-TB drugs carbamazepine much destroys the liver. In complex treatment with other antiepileptic drugs carbamazepine becomes toxic and causes poisoning.
Grapefruit juice increases the concentration of the drug in the blood.
- constant monitoring of indicators of blood and urine during treatment;
- control of intraocular pressure;
- eliminate alcohol, so carbamazepine and alcohol with simultaneous use strongly depress the nervous system;
- the drug effects on psychomotor function, reduces attention and concentration. So if people felt the decline of these qualities (while driving, while performing work requiring concentration), you need to see a doctor, it may be the first symptoms of overdose.
Poisoning carbamazepine requires serious treatment of the physical condition and psyche, long-term rehabilitation. Therefore, in order to avoid overdose, it is necessary to take a strictly prescribed dose of a drug.