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Carbamazepine : Primary care prescribing tips

 Carbamazepine : Primary care prescribing tips

The management of conditions such as epilepsy and trigeminal neuralgia in primary care often involves the use of carbamazepine, a well-established medication with a specific mechanism of action that modulates neuronal activity. The prescribing and monitoring of carbamazepine are complex due to its potential side effects, interactions with other medications, and the necessity for careful patient selection to avoid contraindications.


This table serves as a succinct reference for primary care clinicians, summarizing the essential considerations for the use of carbamazepine, including its pharmacodynamics, safety profile, and required monitoring parameters.

TopicDetails
Mechanism of ActionModulates voltage-gated sodium channels (VGSC), inhibiting action potentials and decreasing synaptic transmission. Also affects other voltage-gated ion channels, like calcium channels.
ContraindicationsAcute porphyrias, AV conduction abnormalities, history of bone marrow depression.
CautionsCardiac disease, history of haematological reactions to other drugs, presence of HLA-B1502 or HLA-A3101 allele, skin reactions, susceptibility to angle-closure glaucoma, and need for vitamin D supplementation in long-term immobilized patients or those with inadequate sun exposure or dietary intake of calcium.
Common Side EffectsDizziness, drowsiness, dry mouth, nausea, vision disorders, skin reactions, hyponatraemia, leucopenia.
Management of Side EffectsSide effects are often dose-related; consider titration or switching to modified-release...

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