What Is Carbamazepine Toxicity?

The anticonvulsant mechanism of Carbamazepine is unclear. It may increase the inactivation of sodium channels, limit post-synaptic neurons and block pre-synaptic Na + channels, thereby limiting pre- and post-synaptic neurons The release of action potentials can block the release of excitatory neurotransmitters, reduce the excitability of nerve cells, and achieve anticonvulsant effects. The mechanism of action against peripheral neuralgia may be related to the regulation of Ca2 + channels.

Basic Information

Drug Name

Carbamazepine

Alias

Carbamazepine, carbamazepine, carbamazepine, chadiannine, chapronin, delidol, deliben, fenproxine, formylbenzazole, carbamazine,

1. The treatment of epilepsy is the first choice for simple and complex partial seizures, and the effect on complex partial seizures is better than other antiepileptic drugs. It is not effective for typical or atypical absence attacks and muscle spasms.

2. Anti-peripheral neuralgia includes trigeminal neuralgia, glossopharyngeal neuralgia, multiple sclerosis, diabetic peripheral neuralgia and postherpetic neuralgia. Can also be used as a long-term preventive medication after trigeminal neuralgia relief. It has better curative effect on trigeminal neuralgia and glossopharyngeal neuralgia than phenytoin sodium. It can be effective after 24 hours of administration.

3. The treatment of neurogenic diabetes insipidus may be caused by promoting the secretion of antidiuretic hormones.

4. To prevent or treat manic depression, clinical use proves that the drug has obvious therapeutic effects on mania and depression, and can also reduce or eliminate manic and delusional symptoms in patients with schizophrenia.

5. Anti-arrhythmic effect, can fight arrhythmia caused by digoxin poisoning. Can make it completely or basically return to normal heart rhythm. Clinical trials have proven that it is effective for both ventricular or supraventricular premature beats, which can eliminate symptoms, especially those with chronic cardiac insufficiency.

1. For anticonvulsions: start 0.1g / time, 2 ~ 3 times / day; increase the daily value by 0.1g after the second day until the curative effect appears; adjust the maintenance amount to the minimum effective amount according to the curative effect, and take it in divided doses; the highest amount Not more than 2g / day.

2. Analgesia: Start at 0.1g / times, 2 times / day; increase by 0.1 0.2g every other day after the second day until the pain is relieved, maintain the amount of 0.4 0.8g / day, take in divided doses; the maximum amount should not exceed 1.2g / day.

3. Diabetes insipidus: 0.3 0.6g / day when used alone, if used in combination with other antidiuretics, 0.2 0.4g / day, divided into 3 doses.

4. Anti-manic or anti-psychotic: 0.2 ~ 0.4g / day at the beginning, it can be increased to a maximum amount of 1.6g / day according to the situation, divided into 3 to 4 times.

5. Pediatric dosage: anticonvulsant, 10-20 mg / kg daily; generally increase gradually from a small dose to the effect.

Common adverse reactions are central nervous system reactions such as blurred vision, diplopia, and nystagmus, as well as dizziness, fatigue, nausea, and vomiting; most often occur 1 to 2 weeks after medication. Rare rash, urticaria, pruritus, child behavior disorder, abnormal liver function, cholestasis, hepatocellular jaundice, and hypothyroidism, etc .; rare agranulocytosis and bone marrow suppression, arrhythmia, allergic hepatitis, liver failure, acute kidney disease Failure and hypersensitivity reactions in multiple organs throughout the body. The US FDA has published reports that carbamazepine may cause severe skin lesions in some patients, such as SJ syndrome and toxic epidermal necrolysis.

1. Be used with caution in glaucoma, severe cardiovascular disease, diabetes, patients who cannot tolerate tricyclic antidepressants, patients with alcoholism, urinary retention, kidney disease and the elderly.

2. Interference to diagnosis: It can increase the test value of aminotransferase, serum bilirubin, alkaline phosphatase, urea nitrogen, urine sugar, etc .; lower the blood calcium concentration, and lower the thyroid function test value.

3. Pay attention to follow-up inspection during the medication (especially within the first month): blood, urine routine, blood urea nitrogen, liver function, thyroid function, and monitoring carbamazepine blood concentration.

4. Due to the self-inducing effect of this product, after the first stage of treatment, it may be necessary to increase the dose to maintain the original blood concentration and seizure control level.

Cardiac, liver, and renal insufficiency, atrioventricular block, severe abnormalities in hemogram, history of bone marrow suppression, and pregnant and lactating women are prohibited.

1. Combined with acetaminophen, can cause liver poisoning.

2.Combined with coumarins, estrogen, cyclosporine, digitalis, levothyroxine and quinidine, this product can induce liver metabolic enzymes, accelerate the metabolism of the above drugs, reduce blood concentration, shorten half-life, and drugs Reduced effect.

3. Combining with phenobarbital, phenytoin, and primidone reduces the blood concentration of carbamazepine.

4. Erythromycin, aceandromycin, cimetidine, isoniazid, and dexpropoxyphene can inhibit the metabolism of carbamazepine, causing the plasma concentration of the latter to increase.

5. In combination with carbonic anhydrase inhibitors, the risk of osteoporosis increases.

6. Combined with monoamine oxidase inhibitor and valproic acid, can increase drowsiness.

7. Combined with lithium salt and antipsychotics, it can easily cause symptoms of central nervous system poisoning.

8. Combined with chlorpromide, clobetin, desmopressin, and posterior pituitary to enhance antidiuretic effect.

9. Reduce the concentration of doxycycline when combined.

Note: The above content is only for introduction, the drug use must be carried out by a regular hospital under the guidance of a doctor.