To determine the rate and factors that affect carbamazepine absorption, six patients being treated in the pediatric intensive care unit for frequent seizures received loading doses (7.4 to 10.4 mg/kg) of carbamazepine suspension by either nasogastric or nasoduodenal tube. Carbamazepine serum concentrations were determined 15, 30, 60, 120, and 480 minutes after administration by fluorescence polarization immunoassay. One patient who had an ileus did not attain therapeutic concentrations (> 4.0 mg/L). The other five patients with normal gastrointestinal function achieved mean serum concentrations at 1 hour and 2 hours of 4.3 mg/L and 7.3 mg/L, respectively. Delayed gastric emptying and concurrent enteral feedings appear to slow the absorption of carbamazepine. No adverse effects were observed. Rapid loading with carbamazepine suspension appears to be a useful alternative for the management of critically ill pediatric patients who are experienced frequent seizures.
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August 1990
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August 01 1990
Rapid Loading of Critically III Patients With Carbamazepine Suspension
Michael V. Miles;
Michael V. Miles
From the Division of Pharmacy Practice, School of Pharmacy, Departments of Pediatrics and Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Stephen T. Lawless;
Stephen T. Lawless
From the Division of Pharmacy Practice, School of Pharmacy, Departments of Pediatrics and Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Michael B. Tennison;
Michael B. Tennison
From the Division of Pharmacy Practice, School of Pharmacy, Departments of Pediatrics and Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Amo L. Zaritsky;
Amo L. Zaritsky
From the Division of Pharmacy Practice, School of Pharmacy, Departments of Pediatrics and Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Robert S. Greenwood
Robert S. Greenwood
From the Division of Pharmacy Practice, School of Pharmacy, Departments of Pediatrics and Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Pediatrics (1990) 86 (2): 263–266.
Article history
Received:
June 28 1989
Accepted:
August 22 1989
Citation
Michael V. Miles, Stephen T. Lawless, Michael B. Tennison, Amo L. Zaritsky, Robert S. Greenwood; Rapid Loading of Critically III Patients With Carbamazepine Suspension. Pediatrics August 1990; 86 (2): 263–266. 10.1542/peds.86.2.263
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