Tegretol level (Carbamazepine)

Sample

• The serum of the patient is needed.

Indications

1. It is advised in Epileptic patients on Tegretol therapy.
2. This may be also used in trigeminal neuralgia.
3. Also, this has a beneficial effect on the glossopharyngeal neuralgia.

Purpose of the test

1. The carbamazepine test is used to measure and monitor the amount of carbamazepine in the blood to determine:
   1. whether the level of the drug is within the therapeutic range.
   2. So the dose of the drug may be adjusted up or down until the blood level reaches the therapeutic range.
2. A routine carbamazepine test measures total carbamazepine,  both protein-bound and free portions of the drug.

Pharmacology

1. Carbamazepine is similar to a tricyclic antidepressant.
   1. Dose = 400 to 1600 mg /day in two doses.
2. This is used to control grand mal and psychomotor seizures.
3. This can help to relieve the pain of trigeminal neuralgia.
4. Its mechanism of action is to reduce synaptic transmission in the spinal cord.
5. This can be used in other seizures where there is pain.
6. Side effects are related to the dose of the drug and these are neurological.
   1. There may be visual and vestibular changes.
   2. There may be ataxia, nausea, and vomiting.
   3. The patient may have a rash and agranulocytosis.
   4. In chronic cases may have a hepatic failure.
7. Metabolism Of the drug is in the liver and its half-life is 5 to 25 hours.

Side effects

1. There may be nausea and vomiting.
2. The patient may get dizziness and drowsiness.
3. There are dry mouth and swollen tongue.
4. Patients may develop a loss of balance.
   1. Stopping drugs may lead to seizures.
5. Contraindicated in the following conditions:
   1. In the case of heart disease.
   2. In patients with liver or kidney disease.
   3. Patients with the presence of glaucoma.
   4. Take care of thyroid diseases.
   5. In case of an autoimmune disease like Lupus.

• Tegretol is an anticonvulsant drug.
• Therapeutic range = 4 to 8 µg/mL.
  Toxic Level = > 20  µg /mL.

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