Important Tegretol Info
Psychiatric Nursing is an interesting branch of practice that deals with patients diagnosed with mental distress and illnesses. The nurse’s therapeutic approach is key for these patients, just like the medications that help the clients overcome their disorders. As such, if you want to be a good psychiatric nurse, you need to master a handful of drugs, such as Tegretol.
Indications for Use
Tegretol, which is the brand name of the drug Carbamazepine, is an anti-epileptic agent. Also known as Carbatrol, Atretol and Epitol, it works by inhibiting poly-synaptic responses and hindering post-tetanic potentiation.
Tegretol is mainly used in patients with refractory seizure disorders, including grand mal and generalized seizures. Apart from these, Carbamazepine is also used in the treatment of bipolar disorder, resistant schizophrenia and other psychiatric maladies.
While it is widely used in mental illnesses, Tegretol is also utilized in other health conditions. For one, it is prescribed as a pain reliever in individuals suffering from Trigeminal Neuralgia. Other unlabeled uses include treatment for Diabetes Insipidus, Restless Leg Syndrome, Chorea and Non-Neuritic Pain Syndrome.
Prior to administering Tegretol, you need to check the patient’s history. Note the presence of carbamazepine/tricyclic anti-depressant allergy and the history of adverse reactions to other drugs. Check if the patient takes MAOIs, or had a history of bone marrow depression. The presence of increased intraocular pressure, renal/cardiac/hepatic damage should be recorded as well.
Physical examination is also important, so make sure to check the patient’s vital signs, as well as his affect, orientation and reflexes. Auscultate the lungs and check the patient’s urinary output and bowel sounds.
Ensure that lab exams such as CBC with platelet and reticulocyte count, Urinalysis, BUN/Creatinine, Serum Iron, Thyroid and Hepatic function tests, as well as ECG, are obtained prior/during the course of Tegretol therapy.
NCLEX Nursing Interventions
Prior to dispensing Tegretol, make sure that the patient has eaten already to prevent GI upset. If you will give ER tablets, advise patient not to crush, chew or cut the drug. Instead, he should take it wholly.
When preparing Tegretol suspension, do not mix it with other drugs or substances as it might precipitate. Additionally, it offers a higher peak level – that is why lower doses should be given at first.
Perhaps the most important nursing intervention is memorizing the therapeutic serum levels of Tegretol, which range from 4 to 12 mcg/ml.
Important NCLEX Teaching Points
The nurse should advise the patient to take Tegretol with food to avoid GI upset. Whole swallowing should also be reinforced, especially in those who are prescribed with ER tablets.
Advise the client to avoid over-the-counter drugs, sleep aids and alcohol, as it might result to adverse side effects. Such signs that warrant the notification of the healthcare provider include abdominal pain, unusual bleeding, pale feces, darkened urine, yellowing of the skin or the eyes, edema and CNS disturbances.
Additionally, educate the patient about the normal side effects of Tegretol, which are blurred vision, drowsiness, dizziness and GI upset.
Most importantly, remind patient not to discontinue or substitute Tegretol abruptly, as it can result to status epilepticus, or a state of persistent seizure.
Memorizing medications is not so hard! Combat your NCLEX woes by parsing through the practice NCLEX questions posted here at nclexpreceptor.com.