Open AccessSuccessful treatment of a case with concurrent ingestion of carbamazepine overdose and grapefruit juice
Author(s) -
Mochizuki Katsunori,
Hamano Yujiro,
Miyama Hiroshi,
Arakawa Kazuki,
Kobayashi Takashi,
Imamura Hiroshi
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.117
Subject(s) - gastric lavage , grapefruit juice , carbamazepine , hemoperfusion , ingestion , activated charcoal , stomach , medicine , gastric fluid , anesthesia , pharmacology , gastroenterology , chemistry , surgery , epilepsy , pharmacokinetics , chromatography , hemodialysis , organic chemistry , adsorption , psychiatry
Case We report a case with concurrent ingestion of carbamazepine ( CBZ ) overdose and grapefruit juice. A 23‐year‐old man, with a history of epilepsy, was admitted to our emergency department 2 h after ingesting 10 g CBZ with 1 L grapefruit juice. On arrival, the patient's G lasgow C oma S cale score was 9 and he showed signs of restlessness. Grapefruit juice‐like gastric fluid, with tablet residue, was observed in his stomach after we inserted a gastric tube. Our initial test detected a blood CBZ level of 41.5 mg/L. Outcome We treated the patient with gastric lavage, activated charcoal, and charcoal hemoperfusion. His blood CBZ level began to decrease after gastrointestinal decontamination, and he was discharged without any sequelae on day 9. Conclusion Gastric lavage or aspiration may be considered in cases where drug residue is found in the stomach, especially if materials are involved that might exacerbate the drug's toxicity.