Name: Carbamazepine (Tegretol)
Class: Antiepileptic Agent (Tonic-Clonic/Complex-Partial)
Mechanism: Blocks voltage-dependent Na+ channels ® inhib. of sustained high-freq repetitive neuron firing.
Absorption:
Dist.: 66-89% protein binding.
Metabolism.:
Excretion, t½: 14-27 hr (adults), 8-28 hr (kids)
Toxicity/S.E.s: Dose-related—double vision, blurred vision, vertigo, cognitive impairment, lethargy, behavioral changes, dyskinesias, cardiac condxn disturbances. Non-dose-rel.—diarrhea, fluid retention. Idiosync.—granulocyte suppression, allergic dermatitis, Stevens-Johnson synd., aplastic anemia, hepatic & kidney failure. Signif. drug interactions (¯ w/phenobarbital, phenytoin, primidone, felbamate).
Utility: A DOC for generalized tonic-clonic seizures. A DOC for 1° & 2° generalized partial and complex-partial seizures. Treatment of pain assoc. w/true trigeminal neuralgia (off-label). Management of acute mania and maintenance of bipolar affective disorder (off-label).