Tegretol (carbamazepine)

Question 1

black box warning for tegretol

Answer 1

agranulocytosis & aplastic anemia

Question 2

Agranulocytosis is

Answer 2

decreased WBCs
White blood cells (WBCs), also known as leukocytes, are part of the body’s immune system and help fight infection and disease:

Question 3

Aplastic anemia s/s (8)

Answer 3

pallor
fatigue
headache
fever
nosebleed
bleeding gum
skin rash
SOB

Aplastic anemia is a rare but serious blood disorder that occurs when the bone marrow is unable to produce enough new blood cells. This can lead to a deficiency of all blood cell types, including red blood cells, white blood cells, and platelets

Question 4

Tegretol can cause Steven Johnson’s syndrome particularly in _______ should screen for _____

Answer 4

Asians
HLAB-1502 allele before initiating

Question 5

HLA-B*1502 allele is highly associated with

Answer 5

Tegretol induced steven johnson’s syndrome

Question 6

Antiepileptics such as ___, ___, ___, are well known for decreasing the effectiveness of ____

Answer 6

Tegretol / Carbamazepine
Topamax / Topiramate
Dilantin / Phenytoin
oral contraceptives

Question 7

Carbamazepine and clozaril can cause ___ and should be monitoring for _________ (5)

Answer 7

agranulocytosis

signs of infection
sudden fever
chills
sore throat
weakness

Question 8

What ANC level warrants the d/c of Clozaril or carbamazepine and why

Answer 8

1000 nm because risk of neutropenia

Neutropenia is a condition where the body has low levels of neutrophils, a type of white blood cell that fights infection.

Question 9

What level of WBC to d/c clozaril and carbamazepine and why

Answer 9

2000-3000 due to risk of agranulocytosis (whether patient shows signs of infection or not)

Question 10

Clozapine can cause what issues to the heart (2)

Answer 10

myocarditis which can be fatal and cardiomyopathy

Question 11

What pre-treatment screening is recommended before starting clozapine

Answer 11

cardiovascular screening