الفهرس | Only 14 pages are availabe for public view |
Abstract Summary CBMZ is a frequently prescribed anticonvulsant and psychotropic and it has many other therapeutic indications. This increasing range of use makes it available in many homes within easy reach of miswatched children and adults vulnerable to suicidal attempts. This increase in incidence of intoxication by CBMZ was noticed in the P.C.C. in the last few years. There is controversy in literature about relation of CBMZ serum levels and the severity of the clinical picture, so this work aimed at correlating clinical state with CBMZ serum levels. 26 cases of acute intoxication with CBMZ presented to the P.C.C. were studied. They were subjected to full history, clinical examination, blood sampling for serum Na+ and serum CBMZ level and electrocardiogram. 50% of these cases were categorized as moderate to severe intoxication necessitating the admission as inpatient or in intensive care units. There was a positive correlation between CBMZ serum levels and the grade of coma. Other findings as respiratory depression and vomiting were seen more in the higher CBMZ serum levels. There was a significant DROP in B.P. in the intoxicated cases with CBMZ. 86 Summary This DROP negatively correlated to CBMZ serum levels. Pulse rate varied where sinus tachycardia was seen more in higher CBMZ serum levels, whilst bradycardia was seen more in moderately elevated CBMZ serum levels. E.C.G. changes were in the form of increased P-R interval which was more in the moderately elevated CBMZ serum levels, whilst wide QRS complex was more in the higher CBMZ levels. Although hyponatremia has been theorized to occur, there were no significant decrease in serum Na+ levels in our study. Our CBMZ intoxicated cases were classified according to line of management and grade of severity as follows: - Outpatient I Non toxic group (11.5%) With CBMZ serum levels s 12 ug/ml - Observation I Mild toxicity (38.5%) With CBMZ serum levels between 12-23.5 ug/ml - Inpatient I Moderate toxicity (27%) With CBMZ serum levels between 23.5-35 ug/ml - Intensive care unit I Severe toxicity (23%) With CBMZ serum levels more than 35 ug/ml All of our CBMZ intoxicated cases were fully recovered and no deaths had occurred. |