OBSERVATION'S |
Carbamazepine is an anticonvulsant drug used for the treatment of generalized and partial seizures, and also for the relief of pain associated with trigeminal neuralgia.1-3 It is becoming the anticonvulsant of choice due to its lower incidence of severe side effects. 4,5 Carbamazepine, an iminostilbene derivative chemically related to the tricyclic antidepressants, appears to control seizures by inhibiting excess electrical discharges in the brain. Carbamazepine is routinely administered orally, absorbed slowly and erratically, and once absorbed is rapidly absorbed into all tissues.1 In plasma, about 75% is bound to protein.1, 2 Carbamazepine is metabolized by oxidative liver enzymes to its active 10,11-epoxide metabolite, which may be present at plasma levels 50% those of carbamazepine. The carbamazepine 10,11-epoxide is then metabolized to inactive compounds, mainly the dihydroxide and glucuronides, which are eliminated in the urive.1, 7-9 The ability of carbamazepine to increase its conversion to metabolites, individual variation in the ability to metabolize carbamazepine and a lack of relationship between increases in dose and changes in plasma concentrations make serum level monitoring necessary for individualized dosing of carbamazepine.1, 2, 7, 8, 10 |
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