Abstract：
Carbamazepine is utilized for various indications. Due to its pharmacokinetic profile and drug properties, toxicity can be delayed and persistent despite supportive care. We report a severe case of intentional carbamazepine toxicity in a carbamazepine naive individual mimicking brain death that was not diagnosed until three days after consumption of carbamazepine when the patient was comatose. Symptoms of overdose persisted for several days despite attempted treatment with activated charcoal and whole bowel irrigation, hemodialysis, and plasmapheresis. Symptoms only began to improve with bowel evacuation as a result of administration of neostigmine intravenously plus hemodialysis and plasmapheresis additionally. Despite previous literature that reported success with hemodialysis and/or plasmapheresis we did not find either to be overly effective in our case possibly due to lack of ability to perform multidose activated charcoal and whole bowel irrigation. To our knowledge this is one of the few cases of carbamazepine overdose utilizing both hemodialysis and plasmapheresis but without activated charcoal and the only case report in which neostigmine was administered as an attempt to remove drug via the gastrointestinal tract with success.
摘要：
卡马西平用于各种适应症。由于其药代动力学特征和药物特性，尽管给予支持治疗,但毒性仍可延迟和持续.我们报告了一例严重的卡马西平幼稚个体中故意卡马西平毒性的病例，该个体模仿脑死亡，直到患者昏迷时服用卡马西平三天后才被诊断出来。尽管尝试使用活性炭和全肠冲洗进行治疗，但过量的症状仍持续了几天，血液透析,和血浆置换.由于静脉注射新斯的明加血液透析和血浆置换，症状仅随着肠排空而开始改善。尽管以前的文献报道了血液透析和/或血浆置换的成功，但我们没有发现在我们的病例中可能由于缺乏进行多剂量活性炭和全肠冲洗的能力而过于有效。据我们所知，这是少数同时使用血液透析和血浆置换但没有活性炭的卡马西平过量使用的病例之一，也是唯一的尝试通过胃肠道成功使用新斯的明的病例报告。
