Drug Study: carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol)

Generic Name: carbamazepine

Brands: Tegretol, Tegretol XR , Equetro, Carbatrol

Preparation:
Tablets: 200 mg. Chewable tablets; 100 mg. Extended release tablets; 100, 200, and 400 mg. Suspension; 100 mg/5 ml. Equetro is available in 100, 200, and 300 mg extended release tablets

CLASSIFI-CATION: Anticonvulstant

ACTION:
• Decreases synaptic transmission in the CNS by affecting sodium channels in neurons

• Prevention of seizures

INDICATION / USES:
• Reduces anxiety, irritability, elation
• Impulse control behavior

COMMON ADVERSE EFFECTS:
•CNS: headache, tremors, confusion, restlessness, memory loss, seizures, slurred speech, muscle weakness, lack of coordination, lethargy, stupor
•CV: bradycardia, ECG changes, arrhythmias, hypotension, peripheral circulatory collapse
•EENT: blurred vision, tinnitus
• GI: anorexia, nausea, vomiting, abdominal cramps or pain, diarrhea, dry mouth, extreme thirst, metallic taste, weight gain
• GU: polyuria, glycosuria, proteinuria, incontinence, edema, hyponatremia
• Hematologic: leukocytosis
• Skin: rash, pruritus, alopecia, sweating, dryness or thinning of hair

CONTRA-INDICATIONS:
• Hypersensitivity
• Kidney disease
• Cardiovascular disease
• Seizure disorder, myasthenia gravis
• Dehydration
• Hypothyroidism

NURSING CONSIDERATIONS:
• Administer medication with food to minimize gastric irritation. Tablets may be crushed if patient has difficulty swallowing. Do not crush or chew extended-release tablets.
• Instruct patient to take carbamazepine around the clock, exactly as directed. If a dose is missed, take as soon as possible but not just before next dose; do not double doses. Medication should be gradually discontinued to prevent seizures.
• May cause dizziness or drowsiness.
• Instruct patients that fever, sore throat, mouth ulcers, easy bruising, petechiae, unusual bleeding, abdominal pain, chills, rash, pale stools, dark urine or jaundice should be reported.
• Advise patient not to take alcohol or other CNS depressant concurrently with this medication.
• Caution patients to use sunscreen and protecting clothing to prevent photosensitivity reactions.
•Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may help reduce dry mouth. Saliva substitute may be used.


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