Paper I
2023 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Carbamazepine

Q63 marksShort Notes

Answer

Carbamazepine is a Na⁺ channel-blocking antiepileptic, structurally related to the tricyclic antidepressants.

MOA: carbamazepinebinds and stabilizes the inactivated state of voltage-gated Na⁺ channels → use-dependent block of sustained high-frequency neuronal firing.

Uses: focal (partial) seizures, generalized tonic-clonic seizures, trigeminal neuralgia (drug of choice), bipolar disorder (mood stabilizer).

Adverse effects: sedation, diplopia, ataxia, hepatic enzyme induction (reduces efficacy of oral contraceptives and other co-administered drugs), hyponatremia (SIADH-like effect), Stevens-Johnson syndrome/toxic epidermal necrolysis (HLA-B*1502 association, particularly relevant in patients of Han Chinese/Southeast Asian ancestry), aplastic anemia/agranulocytosis (rare), teratogenicity. Worsens absence and myoclonic seizures — not used for these seizure types.

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