Arh Hig Rada Toksiko
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Arh Hig Rada Toksiko · Dec 2005
Case ReportsMultidose activated charcoal in the treatment of carbamazepine overdose with seizures: a case report.
Serious complications after carbamazepine poisoning, such as coma, seizures, respiratory failure, cardiac conduction abnormalities, and death are more likely with serum levels greater than 170 micromol L(-1). We report a case of a single massive carbamazepine overdose in a 19-year-old male, following attempted suicide, without prior history of seizure disorder. On admission, three hours after ingestion, serum carbamazepine concentration was 179 micromol L(-1) and Glasgow Coma Scale scored 6. ⋯ Twelve hours after ingestion, two repeated generalised myoclonic seizures were noted when serum carbamazepine levels peaked at 181 micromol L(-1), and were successfully treated with diazepam. Carbamazepine serum level fell within the therapeutic range 63 hours after ingestion and the patient was discharged without any long-term sequelae. As there is no antidote for carbamazepine poisoning, supportive treatment remains the only, but usually potent option.
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The background to and current status of the drink driving law in the United Kingdom is explained. Screening tests and analytical methods for alcohol in blood, breath and urine are described. ⋯ Special reasons why a licence should not be withdrawn are considered together with the effect of medication on alcohol levels. Finally, the question of whether legal limits in the United Kingdom are too high is considered together with whether the punishments imposed are too severe.