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Background/Aim. Saliva is a body fluid which, like serum, can be used for  determination of concentrations of certain drugs, both in pharmacotherapy as  well as in acute poisonings. The aim of this study was to determine  carbamazepine concentrations in both saliva and serum in acute poisoning in  order to show if there is a correlation between the obtained values, as well  as to monitor toxicokinetics of carbamazepine in body fluides. Methods.  Saliva and serum samples were obtained from 26 patients treated with  carbamazepine and 20 patients acutely poisoned by the drug immediately after  their admission in the Emergency Toxicology Unit. Determination of salivary  and serum carbamazepine concentrations was performed by the validated high  pressure liquid chromatographyultraviolet (HPLC-UV) method. Results. A  significant correlation of salivary and serum carbamazepine concentrations in  both therapeutic application and acute poisoning (r = 0.9481 and 0.9117,  respectively) was confirmed. In acute poisonings the mean ratio between  salivary and serum concentrations of carbamazepine (0.43) was similar to the  mean ratio after its administration in therapeutic doses (0.39), but there  were high inter-individual variations in carbamazepine concentrations in the  acutely poisoned patients, as a consequence of different ingested doses of  the drug. In acute poisoning the halftime of carbamazepine in saliva and  serum was 12.57 h and 6.76 h, respectively. Conclusion. Our results suggest a  possible use of saliva as an alternative biological material for  determination of carbamazepine concentrations in therapeutic application and  acute poisoning as well, and a possible extrapolation of the results obtained  in saliva to serum concentrations of carbamazepine

Toxicokinetics and correlation of carbamazepine salivary and serum concentrations in acute poisonings