Question

You are the pediatric nurse caring for Missy, an 8-year-old girl who has been diagnosed with epilepsy. Missy will be hospitalized for at least 3 more days. Missy has been prescribed carbamazepine. You have been assigned to develop the initial teaching plan for Missy and her parents. How will you best prepare to answer these questions?

1. Does the patient need to follow the time frame established for administration of the drugs used in her treatment?

2. How can Missy and her parents assist the healthcare team in determining how her seizures can best be treated?

3. What are the action, side effects, and precautions needed for carbamazepine?

Answer 1

8 yr old Missy is diagnosed with EPILEPSY and is started on CARBAMAZEPINE.

ANS 1 - YES, patient definitely needs to follow the time frame established for administration of the drugs used in her treatment because missing a drug can lead to seizure again which is called as BREAKTHROUGH SEIZURE.

ANS 2 - How her seizures canbe best treated?, It is best treated with keeping in mind following things, FIRST AND FOFEMOST is that her parents should give a detail of seizure to Makeout what type of seizure was it?, whether a generalised tonic clonic seizure or myoclonic or absence seizure. After that this following things will be advised by healthcare team to her parents.

a) Taking medication regularly and not missing the dose

b) Avoiding swimming as it may cause harm if seizure come while swimming as she may drown.

c) Coming for regular follow up to know the action of drug and if she requires increase or decrease in dose or change in drugs

d) Parents should be informed about common and possible side effects which may occur for which they need to consult doctor soon.

ANS 3- ACTION - CARBAMEZEPINE is an anti-convulsant drug, it acts by BLOCKING SODIUM RECEPTOR INBRAIN NEURONS which prevents excitstion of neurons and there by controlling seizure activity.

ADVERSE EFFECTS - Common are due to neurotoxicity - sedation, dizziness, vertigo, diplopia and ataxia. Others are Vomiting, diarrhoea, hypersensitivity reactions like rashes,hepatitis,and rarely agranulocytosis and aplastic anaemia

PRECAUTIONS - Carbamazepine is an enzyme inducer so can reduce efficacy of drugs like haloperidol, valproate and topiramate. Metabolism of carbamazepine is induced by phenobarbitone, phenytoin which decreases efficacy of carbamezepine. Erythromycin, fluoxetine, isoniazid inhibits metabolism of carbamezepine. So if she is also on any other drug then dose management is required accordingly