تعیین سطح خونی کاربامازپین در بیماران و مسمومین و بررسی رابطه آن با علائم بالینی و آزمایشگاهی

ABSTRACT: Our proposed method for determination of carbamazepine (CBZ) is spectrophotometric assay. This method is based on the catalytic rearrangement of CBZ to 9-methyl acridine ,and the absorbance was measured at 258 nm against a reagent blank. A turnaround time of 40 min makes this method well suited for emergency cases. Precision, sensitivity and recovery of this method are all suitable. CBZ overdose was confirmed in 32 patients admitted to hospitalization from 8 April until 10 July 1996. These patients had a mean age of 22 years and 34% were Known epileptics.All patients had attempted suicide. They ingested a mean of 3 gr CBZ, with 70% of cases involving coingested other drugs. The clinical manifestations of toxicity formed a recognisable clinical picture of diminished conscious state(100% of patients ),nystagmus and diplopia (71.8%) ataxia(62.5%) abnormal deep tendon reflexes(31.2%) and mydriasis(15.8%).62% showed hyponatremia and 43.7% had transient evidence of hepatic dysfunction .Determination of serum CBZ level in these patients by spectrophotometric method was predictive of toxicity. Our results indicate that determintion of CBZ in plasma has valuable effects on patients treatment, or indication for hemoperfusion and also for prognosis.