Carbamazepine Flashcards
What are the indications for carbamazepine?
Focal and secondary generlised tonic-clinic seizures
Primary generalised tonic clonic seizures
Trigeminal neuralgia
Prophylaxis of bipolar disorder unresponsive to lithium
Adjunct in acute alcohol withdrawal
Diabetic neuropathy
What is the therapeutic range of carbamazepine?
4 -12 mg/L
When should carbamazepine levels be taken?
1 to 2 weeks after
What are the signs of carbamazepine toxicity?
Hyponatraemia
Ataxia
Nystagmus
Drowsiness
Blurred vision
Arrhythmias
GI disturbances
HANDBAG
What monitoring is needed with Carbamazepine?
FBC, U&E, LFT
What are important points to know about carbamazepine?
- Report any warning signs
- Stay on the same brand
- Inform DVLA –> seizures and driving
- Pregnancy prevention
- Risk of suicidal thoughts
Main general interactions:
Hepatotoxic drugs
CYP inducers
CYP inhibitors
Drugs that lower seizure threshold
Hyponatraemic drugs
What are the common side effects of Carbamazepine
Depression and suicide
Hepatotoxicity
Hypersensitivity
Blood dyscrasias
Vitamin D deficiency –> bone pain
What are the distinguishing side effects of Carbamazepine?
Hyponatraemia
Oedema
What effect does carbamazepine have on CYP enzyme substrates
It’s an Enzyme Inducer
Carbamazepine and Orlistat
Risk of convulsions
Carbamazepine and Melfoquine or antipsychotics
Risk of convulsions
