From unknown poisoning to carbamazepine poisoning

Natasa Simonovska; Andon Chibishev; Niko Bekarovski; Aleksandra Babulovska; Biljana Ivanova; Kiril Naumovski; Kristin Kostadinovski

doi:10.4081/ecj.2023.11270

Authors

Natasa Simonovska
n.simonovska@yahoo.com
University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0002-6259-4882
Andon Chibishev University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0003-4071-3761
Niko Bekarovski University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0002-2563-1795
Aleksandra Babulovska University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0001-9277-9354
Biljana Ivanova Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0009-0002-5499-4613
Kiril Naumovski University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0001-6706-5018
Kristin Kostadinovski University Clinic for Toxicology; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia. https://orcid.org/0000-0002-3658-3899

In the 2020 annual report of the American Association of Poison Control Centers, 2562 toxic exposures to carbamazepine have been reported, 908 resulted in hospitalization, and among these about 5-6% were life-threatening or resulted in significant disability. A 15-year-old female patient was brought under suspicion of alcohol poisoning. The result of alcoholemia was 11.0mg/dL and the toxicological screening for THC, opiates, methadone, tramadol, amphetamine, MDMA, cocaine, benzodiazepines, buprenorphine was negative. At admission she was comatose (GCS=6), with metabolic acidosis, hypotension, rare short-term partial seizures, isochoric and later dilated pupils, body temperature was 36.4°C, with oxygen saturation from 89 up to 93%. Toxicological analysis were immediately extended. After three hours of admission, a result was obtained where the plasma concentration for carbamazepine was 167mmol/L. The patient was quickly prepared for hemodialysis which was performed for four hours. After 8 hours of admission the patient woke up with stable vital parameters.

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Simonovska, N., Chibishev, A., Bekarovski, N., Babulovska, A., Ivanova, B., Naumovski, K., & Kostadinovski, K. (2023). From unknown poisoning to carbamazepine poisoning. Emergency Care Journal, 19(2). https://doi.org/10.4081/ecj.2023.11270