A nurse is teaching a client who has been prescribed carbamazepine (Tegretol) for tonic-clonic seizures. Which of the following statements should the nurse include in the teaching? (Select all that apply.)
A.
You may experience drowsiness or dizziness while taking this medication.
B.
You should avoid grapefruit juice while taking this medication.
C.
You should have your blood pressure checked regularly while taking this medication.
D.
You should report any signs of bleeding or bruising to your provider.
E.
You should use a reliable form of contraception while taking this medication.
The correct answer and Explanation is :
The correct answers are:
A. You may experience drowsiness or dizziness while taking this medication.
B. You should avoid grapefruit juice while taking this medication.
D. You should report any signs of bleeding or bruising to your provider.
E. You should use a reliable form of contraception while taking this medication.
Explanation:
Carbamazepine (Tegretol) is an anticonvulsant medication commonly prescribed to manage tonic-clonic seizures, trigeminal neuralgia, and bipolar disorder. It works by reducing abnormal electrical activity in the brain. While effective, carbamazepine has various side effects and interactions that patients must be aware of.
A. Drowsiness or dizziness:
Carbamazepine often causes central nervous system (CNS) side effects like dizziness, drowsiness, and ataxia, especially when therapy is initiated. These symptoms usually subside as the body adjusts to the medication, but patients should be cautious when performing activities that require alertness, such as driving.
B. Avoid grapefruit juice:
Grapefruit juice can inhibit the enzyme CYP3A4, which is involved in the metabolism of carbamazepine. This can lead to increased serum levels of the drug, elevating the risk of toxicity, including serious side effects like dizziness, ataxia, or even life-threatening conditions such as aplastic anemia or Stevens-Johnson syndrome.
D. Signs of bleeding or bruising:
Carbamazepine can cause bone marrow suppression, leading to blood dyscrasias such as thrombocytopenia (low platelet count). This condition may manifest as easy bruising, prolonged bleeding, or other signs of coagulopathy. Patients should immediately report these symptoms as they may require prompt medical attention.
E. Contraception:
Carbamazepine is a known teratogen and can decrease the effectiveness of hormonal contraceptives. Women of childbearing age should use reliable contraception to prevent pregnancy and discuss family planning with their healthcare provider.
C. Blood pressure monitoring is not commonly necessary for carbamazepine, which mainly affects the CNS and hematological systems.