Carbamazepine

When ATH:
N03AF01

Characteristic.

White or almost white crystalline powder. Practically insoluble in water, soluble in ethanol and acetone. Molecular weight 236,27.

Pharmacological action.
Anticonvulsant, antiepileptic, antipsychotic, timolepticheskoe, normotimicheskoe, analgesic.

Application.

Epilepsy (except little evil), mania, prevention of manic-depressive disorder, Alcoholic withdrawal, trigeminal and language-pharyngeal nerve, diabetic neuropathy.

Contraindications.

Hypersensitivity (incl. the tricyclic antidepressants), OF блокада, myelosuppression or acute porphyria history.

Pregnancy and breast-feeding.

Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)

Side effects.

Dizziness, excitation, hallucinations, depression, violent behavior, activation psychosis, headache, diplopia, accommodation disturbances, cataract, nistagmo, conjunctivitis, noise in ears, change in taste, speech disorders (dysarthria, gibberish), abnormal involuntary movements, peripheral neuritis, paresthesia, muscle weakness and symptoms of paresis, OF блокада, congestive heart failure, Hyper- or hypotension, thromboembolism, renal dysfunction, interstitial nephritis, nausea, vomiting, elevated liver enzymes, jaundice, hepatitis, osteomalacia, sexual dysfunction, moderate leukopenia, thrombocytopenia, violation of hematopoiesis, giponatriemiya, multiorgan delayed-type hypersensitivity, exfoliative dermatitis, lupus-like syndrome (skin rash, hives, hyperthermia, sore throat, joints, weakness), Stevens-Johnson syndrome, Layella, anaphylactic reactions.

Cooperation.

Incompatible with MAO inhibitors. Increases the hepatotoxicity of isoniazid. Reduces the effects of anticoagulants, anticonvulsants (hydantoin derivatives, or succinimides), ʙarʙituratov, clonazepam, prymydona, valproic acid. Fenotiazinы, pimozid, tioksantena enhance CNS depression; cimetidine, clarithromycin, diltiazem, verapamil, Erythromycin, propoxyphene impair metabolism (increased risk of toxicity). It decreases the activity of corticosteroids, estrogens and oral contraceptives estrogensoderjath, xinidina, cardiac glycosides (induction of metabolism). Against the background of carbonic anhydrase inhibitors increase the risk of osteopenia.

Overdose.

Symptoms: disorientation, drowsiness, excitation, hallucinations and coma, blurred vision, dysarthria, nistagmo, ataxia, dyskinesia, hyper / hyporeflexia, convulsions, myoclonus, gipotermiя; respiratory depression, pulmonary edema; tachycardia, hypo / hypertension, cardiac arrest, accompanied by loss of consciousness; vomiting, reduced motility of the colon; fluid retention, oliguria or anuria, changes in laboratory parameters: giponatriemiya, possible metabolic acidosis, giperglikemiâ, increased muscle creatinine phosphokinase fraction.

Treatment: induction of vomiting or gastric lavage, the appointment of activated charcoal and a saline laxative, diurez. To maintain patency of the Airways — tracheal intubation, artificial respiration and (or) use of oxygen. If hypotension or shock-plazmozameniteli, dopamine or dobutamine, with the emergence of convulsing-introduction of benzodiazepines (diazepam) or other. anticonvulsants (children may increase respiratory depression, in developing giponatriemii — fluid restriction, cautious in / infusion of isotonic sodium chloride solution. With the combination of severe poisoning with renal insufficiency shows kidney dialysis. The specific antidote is absent. It is anticipated the re-strengthening of the symptoms of overdose on the 2nd and 3rd day after its start, due to the slow absorption of the drug.

Dosing and Administration.

Inside, adults-100-1600 mg per day (depending on the indication and the severity of the disease), children — 10-20 mg/kg/day in a few receptions.

Precautions.

Before and during therapy is recommended regular blood tests (cellular elements) and urine, control of liver function tests. Be wary appointed with a history of heart disease, liver or kidney problems, when hematological disorders, increased intraocular pressure, latent psychosis, inadequate response to external stimuli, excitation, diseases, characterized by spasms of mixed character, in old age, drivers of vehicles and persons, exploiting mechanisms. Do not suddenly stop treatment. Women are recommended additional intake of folic acid (prior to pregnancy or during); in order to prevent excessive bleeding during the last weeks of pregnancy and the newborn can use vitamin K.

Cooperation