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study guide 4

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What blood values should be monitored with carbamazepine?  Carbamazepine therapeutic range is 4 to 12 mcg/L.  Higher levels can lead to toxic adverse effects. Hypertension, tachycardia, ECG chan ... ges, stupor, agitation, nystagmus, urinary retention, respiratory depression, seizures, and coma.  Children and elderly patient may develop toxicity levels below 12.  CBC every 3 to 4 months, Affects RBC, WBC, Platelets, Agranulocytosis, Anemia, liver function tests, TSH, 2. What is the pharmacodynamics of carbamazepine (Tegretol)?  The exact mechanism of action of carbamazepine is not known, but they are thought to affect the sodium channels, slowing influx of sodium in the cortical neurons and slowing the spread of abnormal activity.  Carbamazepine is metabolized in the liver, effects NA (sodium) channels slowing influx of NA in cortical neurons and slowing spread of ABN activity.  induces the metabolism of many CYP450 enzymes and other substances.  half-life of about 30 hours, shortens to 15 hours when given repeatedly  Carbamazepine exerts its effect by depressing transmission in the nucleus ventralis anterior of the thalamus. This area is associated with the spread of seizure discharge.  Carbamazepine is absorbed through the stomach  The drug is highly lipophilic, resulting in high body tissue binding.  Excretion is through feces and urine.  Average blood levels of carbamazepine occur approximately 6 hours after administration. Half-life can be as long as 65 hours with initial dosing, but is typically 12 to 17 hours as administration continues. [Show More]

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