Carbamazepine (Tegretol) Nursing Considerations

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Outline

Generic Name

Carbamazepine

Trade Name

Tegretol

Indications

Seizures, DM neuropathy, pain associated with trigeminal neuralgia

Action

Affects Na channels in neurons leading to decreased synaptic transmission

Therapeutic Class

Anticonvulsant

Pharmacologic Class

Dibenzazepine

Nursing Considerations

• Interferes with oral contraceptives
• Do not use with MAOIs
• May cause suicidal thoughts
• May cause Stevens-Johnson syndrome, agranulocytosis, aplastic anemia,
thrombocytopenia
• Do not consume grapefruit juice while taking this medication
• Monitor CBC and platelet count
• Monitor serum blood levels of medication often

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Transcript

Hey guys, let’s talk about Carbamazepine also known as Tegretol. This is an oral medication, as you can see here in the picture, and also can be given IV. Okay. So when we think about the therapeutic and pharmacologic class of Carbamazepine, remember that the therapeutic class is what the drug does in the body while the pharmacologic class is the chemical effect. So Carbamazepine is an anticonvulsant with the pharmacologic class being a Dibenzazepine. So how does Carbamazepine work? It affects sodium channels in neurons, which leads to decreased synaptic transmission. Carbamazepine is indicated for seizures, diabetic neuropathy, and pain that is associated with trigeminal neuralgia, which is based nerve pain in the face. So some side effects that are seen with Carbamazepine or Tegretol are nausea, vomiting, dry mouth, and sometimes dizziness. And sometimes, guys, with older adults, Tegretol has been known to cause confusion. 

Okay. Let’s take a look at a few nursing considerations for Carbamazepine. This medication can increase the risk of certain conditions like Steven Johnson syndrome, agranulocytosis or low white blood cell count, aplastic anemia, and thrombocytopenia or low platelet count. Also, be sure to monitor the patient’s medication serum blood levels, as doses are based on these blood levels. Also, monitor the CBC and platelet count. It’s important to mention that grapefruit juice should not be consumed while taking this medication. And when comes to other medications, the patient should not take Carbamazepine with MAOIs. Be sure to teach the patient that oral contraceptives may not be effective and Carbamazepine may cause suicidal thoughts. So guys, Carbamazepine, although not common has been linked to some extremely serious dermatologic issues like toxic epidermal necrolysis, which has a genetic component, which is 10 times higher in those of Asian descent. So with these patients, genetic testing might be necessary. And finally, it’s important to know that absorption is slow with steady-state not being reached for two to five days with Carbamazepine. That’s it for Carbamazepine or Tegretol. Now go out and be your best self today. And as always happy nursing.

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