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Mood Stabilizers > Carbamazepine > Flashcards

Carbamazepine Flashcards

1
Q

Carbamazepine
Brand Names

A

Tegretol
Tegretol XR
Carbatrol
Epitol
Equetro

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2
Q

Carbamazepine
Formulations

A

ER capsule: 100mg, 200mg, 300mg
Oral suspension: 100mg/5mL
Tablet: 200mg
Chewable tablet: 100mg
XR tablet: 100mg, 200mg, 400mg

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3
Q

Carbamazepine
On-Label Indications

A

Bipolar disorder:
Acute hypomania, acute mild-moderate mania
Seizures
Neuropathic pain

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4
Q

Carbamazepine
Off-Label Indications

A

Bipolar depression
Bipolar maintenance

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5
Q

Carbamazepine
MOA

A

Antiepileptic
Blocks VSSCs

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6
Q

Carbamazepine
CYP450 Pathway

A

CYP3A4

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7
Q

Carbamazepine
Dose Range (Adult)

A

400-1200mg/day in 2-4 divided doses

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8
Q

Carbamazepine
Titration

A

Start 100-400mg/day
IR: 2-4 divided doses
ER: BID
Incr by 200mg/day Q4d
Maximum dose: 1600mg/day

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9
Q

Carbamazepine
Dosing (Elderly)

A

Same as adult

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10
Q

Carbamazepine
Dosing (Liver Impairment)

A

No dosage adjustments

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11
Q

Carbamazepine
Dosing (Kidney Impairment)

A

Adjust based on pt response, tolerability, and serum levels

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12
Q

Carbamazepine
OB Considerations

A

Reduces effectiveness of contraceptives, backup method
Teratogenic, contraindicated in pregnancy
Not recommended for breastfeeding

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13
Q

Carbamazepine
Side Effects

A

Bone marrow suppression (anemia, thrombocytopenia, etc.)
Increased risk heart failure, tachycardia
Hepatotoxicity

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14
Q

Carbamazepine
Contraindications

A

TCA cross-sensitivity
Pregnancy
Liver disease

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15
Q

Carbamazepine
Interactions

A

MAOIs - 14 day washout period
“Interacts with everything”
Check with pharmacist when prescribing, avoid polypharmacy

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16
Q

Carmabazepine
Required Monitoring

A

Baseline and periodic:
CBC with plt count, reticulocytes, iron, liver/renal fx, urinalysis, BUN, sodium, opthalmic exam (IOP)
Therapeutic drug monitoring

17
Q

Carbamazepine
Therapeutic Drug Levels

A

4-12mcg/mL
Toxic level: >15mcg/mL

18
Q

Carbamazepine
Pearls

A

Interacts with everything
Rarely rx’d unless pt also epileptic or failed other mood stabilizers

Mood Stabilizers (5 decks)

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