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Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children
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Carbamazepine, Side effects of carbamazepine, Mechanism of action of carbamazepine, dosing of carbamazepine in paediatrics and children

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  • 1. CARBAMAZEPINE IN PAEDIATRICS By : Vijit Agrawal, B.Pharm Pharm.D 5th Year JSS College of Pharmacy, Mysore - 570015
  • 2. Doses Indicated in Epilepsy DOSE DOSE FOR PAEDIATRICS INITIAL DOSE MAXIMUM DOSEAGE< 6 Yrs 10-20 mg/kg/day PO q6hr Not to exceed 35 mg/kg/day6-12 Yrs 50 mg PO q6hr Not to exceed 1000 mg/day> 12 Yrs 200 mg PO q6hr Not to exceed 1000 mg/day12-15 Yrs 200 mg PO q6hr Not to exceed 1200 mg/day Drug should be taken with food.
  • 3. Monitoring• CBC• Blood chemistry• Kidney and liver function tests• Eye exams• Carbamazepine blood levels [ (4-12 mg/L) or (16.9-50.8 micromoles/L) ]
  • 4. Serious Interactions• Tenofovir (Decreased level of Tenofovir)• Linezolid (Increase toxicity)• Selegiline (Increase toxicity)
  • 5. ADRs >10%• Ataxia (15%) (lack of voluntary muscle movements)• Dizziness (44%)• Drowsiness (32%)• Nausea (29%)• Vomiting (18%)
  • 6. ADRs Cont… 1-10 %• Dry Mouth (10%) Rare• MI• Stevens-Johnson syndrome (HLA-B*1502) BLACK BOX WARNING• TEN (HLA-B*1502)• Hepatic failure• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • 7. Contraindications• Documented hypersensitivity• History of bone marrow suppression• Administration of MAO inhibitors within last 14 days• Coadministration with nefazodone (Decresed Level)• Coadministration with NNRTIs (Reduce NNRTI serum concentration)• Jaundice, hepatitis• Pregnancy (especially first trimester: risk of fetal carbamazepine syndrome)
  • 8. Pregnancy & Lactation• Pregnancy category : D• Lactation: Enters breast milk; not recommended D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
  • 9. Mechanism of Action• Stabilizes inactivated state of sodium channels, thereby making neurons less excitable
  • 10. Pharmacology Absorption• Bioavailability: 85% (oral suspension) Distribution• Protein bound: 75-90%• Vd: 1.5 L/kg (neonates); 1.9 L/kg (children); 0.59-2 L/kg (adults) Metabolism• Via hepatic CYP3A4• Enzymes induced: CYP1A2, CYP2C9, CYP3A4 Elimination• Half-life: 25-65 hr (initial dosing); decreases to 10-20 hr after autoinduction• Excretion: Urine (72%)
  • 11. Pharmacogenomics• It is estimated that 1 in 20 patients with HLA-B*1502 will have a severe dermatologic reaction (eg, TEN, SJS) when taking carbamazepine.

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