Valproic acid And Carbamazepine Essay Discussion
write a drug study of valproic acid (Depakote) and carbamazepine (Tegretol)?
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This solution was written by a subject matter expert. It’s designed to help students like you learn core concepts.
write a drug study of valproic acid (Depakote) and carbamazepine (Tegretol)?
Expert Answer
This solution was written by a subject matter expert. It’s designed to help students like you learn core concepts. Valproic acid And Carbamazepine Essay Discussion
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1 ) Valproic acid (sodium Valproate) is a carboxylic acid derivative. Brand name- Dizantil, Epilim. • It is a broad spectrum anti epileptic drug. # Pharmacokinetics:- It is rapidly absorbed from gastrointestinal tract, highly about 90% to plasma proteins. It is metabolized in liver and excreted through urine.
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# Mechanism of action:- • Valproic acid delays the recovery of sodium channels from inactivation. • It also blocks T- type calcium current in thalamic neurons • It increases the activity of GABA by : increasing synthesis of GABA by stimulating glutamic acid decarboxylase enzyme and decreases degradation of GABA by inhibiting GABA-T enzyme (GABA – transaminase). # Indications:- • Valproic acid is highly effective in myoclonic seizures, absence seizures, partial seizures and GTCS . • It is also used in mania, bipolar disorder and also used in migraine prophylaxis. # Contraindications:- • Hepatic diseases or severe hepatic dysfunction . • Known hypersensitivity reaction to this drug. • Urea cycle disorders. Valproic acid And Carbamazepine Essay Discussion
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# Adverse effects:- • Common side effects include nausea, vomiting, Anorexia . • Rare but serious complication like Fulminant hepatitis, so avoided in children younger than 3 years . There must be monitoring of hepatic function during Valproate therapy. • Teratogenicity: Neural tube defects, orofacial and digital abnormalities, so shouldn’t be given in pregnancy. • Skin rashes, alopecia,acute pancreatitis rarely. # Nursing responsibility:- • Dosage should be increased more slowly and with regular monitoring for fluid and nutritional intake, dehydration, somnolence, and other adverse reactions. Dose reductions or discontinuation of valproate should be considered in patients with decreased food or fluid intake. • Monitoring of liver function test , especially in the first six months. • Measuring serum VPA (valproic acid) levels at 24 hr is recommended and provides a more accurate value for patients on OD dosage.
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2 ) Carbamezapine: Belongs to Iministilbenes. It is chemically related to tricyclic antidepressants. Brand names – Tegretol, Epitol. # Pharmacokinetics:- It is slowly absorbed from gIT , binds to plasma proteins, well distributed in the body and metabolized in the liver. • Repeated used of carbamezapine can cause enzyme induction and reduces the effectiveness of drug itself ( auto induction) . # Mechanism of action:- • Carbamezapine binds to voltage dependant sodium channels and prevent further entry of sodium ions into neurons —->Inhibit generation of repetitive action potentials —> therefore prevent the spread id seizure discharges. # Indications:- • Most commonly used anti epileptic. It is drug of choice for GTCS, partial seizures and also in trigeminal neuralgia. • Also used in the treatment of bipolar disorder and acute mania. # Contraindications:- • Carbamazepine is contraindicated in patients with bone marrow depression. Hypersensitivity to this drug or tricyclic compounds such as amitriptyline. # Adverse effects:- • Common effects include drowsiness, sedation,vertigo, diplopia, nausea, vomiting and confusion. • Hypersensitivity reactions like skin rash, lymphadenopathy,eosinophilia . • On chronic use it can cause water retention due to release of ADH. # Nursing responsibility:- • Observe for confusion and agitation in older people. • Observe for changes in mental state and also Observe for allergic reactions such as rashes, purpura. • complete blood count at initiation and periodic hepatic and renal function monitoring.
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Final answer
1 ) Valproic acid (sodium Valproate) is a carboxylic acid derivative. Brand name- Dizantil, Epilim. • It is a broad spectrum anti epileptic drug. # Pharmacokinetics:- It is rapidly absorbed from gastrointestinal tract, highly about 90% to plasma proteins. It is metabolized in liver and excreted through urine. 2 ) Carbamezapine: Belongs to Iministilbenes. It is chemically related to tricyclic antidepressants. Brand names – Tegretol, Epitol. # Pharmacokinetics:- It is slowly absorbed from gIT , binds to plasma proteins, well distributed in the body and metabolized in the liver. • Repeated used of carbamezapine can cause enzyme induction and reduces the effectiveness of drug itself ( auto induction) Valproic acid And Carbamazepine Essay Discussion .
Step-by-step
1st step
All steps
Answer only
Step 1/4
1 ) Valproic acid (sodium Valproate) is a carboxylic acid derivative. Brand name- Dizantil, Epilim. • It is a broad spectrum anti epileptic drug. # Pharmacokinetics:- It is rapidly absorbed from gastrointestinal tract, highly about 90% to plasma proteins. It is metabolized in liver and excreted through urine.
Step 2/4
# Mechanism of action:- • Valproic acid delays the recovery of sodium channels from inactivation. • It also blocks T- type calcium current in thalamic neurons • It increases the activity of GABA by : increasing synthesis of GABA by stimulating glutamic acid decarboxylase enzyme and decreases degradation of GABA by inhibiting GABA-T enzyme (GABA – transaminase). # Indications:- • Valproic acid is highly effective in myoclonic seizures, absence seizures, partial seizures and GTCS . • It is also used in mania, bipolar disorder and also used in migraine prophylaxis. # Contraindications:- • Hepatic diseases or severe hepatic dysfunction . • Known hypersensitivity reaction to this drug. • Urea cycle disorders.
Step 3/4
# Adverse effects:- • Common side effects include nausea, vomiting, Anorexia . • Rare but serious complication like Fulminant hepatitis, so avoided in children younger than 3 years . There must be monitoring of hepatic function during Valproate therapy. • Teratogenicity: Neural tube defects, orofacial and digital abnormalities, so shouldn’t be given in pregnancy. • Skin rashes, alopecia,acute pancreatitis rarely. # Nursing responsibility:- • Dosage should be increased more slowly and with regular monitoring for fluid and nutritional intake, dehydration, somnolence, and other adverse reactions. Dose reductions or discontinuation of valproate should be considered in patients with decreased food or fluid intake. • Monitoring of liver function test , especially in the first six months. • Measuring serum VPA (valproic acid) levels at 24 hr is recommended and provides a more accurate value for patients on OD dosage.
Step 4/4
2 ) Carbamezapine: Belongs to Iministilbenes. It is chemically related to tricyclic antidepressants. Brand names – Tegretol, Epitol. # Pharmacokinetics:- It is slowly absorbed from gIT , binds to plasma proteins, well distributed in the body and metabolized in the liver. • Repeated used of carbamezapine can cause enzyme induction and reduces the effectiveness of drug itself ( auto induction) . # Mechanism of action:- • Carbamezapine binds to voltage dependant sodium channels and prevent further entry of sodium ions into neurons —->Inhibit generation of repetitive action potentials —> therefore prevent the spread id seizure discharges. # Indications:- • Most commonly used anti epileptic. It is drug of choice for GTCS, partial seizures and also in trigeminal neuralgia. • Also used in the treatment of bipolar disorder and acute mania. # Contraindications:- • Carbamazepine is contraindicated in patients with bone marrow depression. Hypersensitivity to this drug or tricyclic compounds such as amitriptyline. # Adverse effects:- • Common effects include drowsiness, sedation,vertigo, diplopia, nausea, vomiting and confusion. • Hypersensitivity reactions like skin rash, lymphadenopathy,eosinophilia . • On chronic use it can cause water retention due to release of ADH. # Nursing responsibility:- • Observe for confusion and agitation in older people. • Observe for changes in mental state and also Observe for allergic reactions such as rashes, purpura. • complete blood count at initiation and periodic hepatic and renal function monitoring.
Final answer
1 ) Valproic acid (sodium Valproate) is a carboxylic acid derivative. Brand name- Dizantil, Epilim. • It is a broad spectrum anti epileptic drug. # Pharmacokinetics:- It is rapidly absorbed from gastrointestinal tract, highly about 90% to plasma proteins. It is metabolized in liver and excreted through urine. 2 ) Carbamezapine: Belongs to Iministilbenes. It is chemically related to tricyclic antidepressants. Brand names – Tegretol, Epitol. # Pharmacokinetics:- It is slowly absorbed from gIT , binds to plasma proteins, well distributed in the body and metabolized in the liver. • Repeated used of carbamezapine can cause enzyme induction and reduces the effectiveness of drug itself ( auto induction) . Valproic acid And Carbamazepine Essay Discussion