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Carbamazepine: Drugs
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Carbamazepine is an anticonvulsant and specific analgesic used in the treatment (pain relief) of trigeminal neuralgia in cases of epilepsy. The drug appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. This drug is very specific and can cause confusion, restlessness, and nervousness in adults and may have affects on the cardiovascular system. Side effects can be severe and should be closely monitored. The more serious include black and tarry stools, blood in the urine or stools, joint pain, darkening of urine, and nosebleeds or unusual bleeding. Carbamazepine is a white to off-white powder, practically insoluble in water and soluble in alcohol and in acetone.
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Carbamazepine is an antiepileptic drug used to reduce or suppress seizures. The medication is ... commonly prescribed to relieve certain neurogenic pain such as trigeminal neuralgia. This drug decreases abnormal electrical impulses through nerve cell pathways by inhibiting the activity of sodium channels in neurons. Consequently, it blocks the repetitive impulses that trigger seizures. In the United States, brand names for carbamazepine include Tegretol, Carbatrol, and Epitol. This medication is classified into the following categories: anticonvulsant, antimanic, and antineuralgic.
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Carbamazepine-10,11 epoxide has anticonvulsant activity similar to that of the parent compound. The half-life averages 6 hours and is 60% bound to protein.1 This heterocyclic (iminostilbene) compound has potent antiepileptic properties and is effective alone or with other antiepileptic drugs in partial seizures, especially complex partial seizures, generalized tonic-clonic seizures, and combinations of these seizure types. Carbamazepine generally is ineffective for absence, myoclonic, and atonic seizures. In children with symptomatic generalized epilepsy and continuous spike-and-wave discharge, these seizure types may develop (or tonic-clonic seizures may increase in frequency) with the use of carbamazepine.
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Carbamazepine has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizures. It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. Carbamazepine greatly reduces or abolishes pain induced by stimulation of the infraorbital nerve in cats and rats. It depresses thalamic potential and bulbar and polysynaptic reflexes, including the linguomandibular reflex in cats. Carbamazepine is chemically unrelated to other anticonvulsants or other drugs used to control the pain of trigeminal neuralgia. The mechanism of action remains unknown.
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Carbamazepine interacts with multiple drugs and caution should be used in combining other medicines with it. Lower levels of carbamazepine are seen when administrated with phenobarbital, phenytoin (Dilantin), or primidone (Mysoline). Warfarin (Coumadin), phenytoin (Dilantin), theophylline, and valproic acid (Depakote, Depakote ER, Depakene, Depacon) are more rapidly metabolized with carbamazepine, while carbamazepine levels are elevated when taken with erythromycin, cimetidine (Tagamet), propoxyphene (Darvon), and calcium channel blockers. Carbamazepine ... increases the metabolism (destruction) of the hormones in birth control pills and can reduce the effectiveness of birth control pills. Unexpected pregnancies have occurred in patients taking both carbamazepine and birth control pills
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Carbamazepine is classified as category "C". That is to say, studies in animals have revealed adverse effects on the fetus but there are no controlled studies in women. Minor malformations such as those seen with fetal hydantoin syndrome have been observed with carbamazepine monotherapy. However, carbamazepine has been recommended as the drug of choice in women at risk of pregnancy who require anticonvulsant therapy for the first time (Briggs et al., 1986).
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