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Gastric lavageEven when more than 4 hours have elapsed following ingestion of the drugthe stomach should be repeatedly irrigatedespecially if the patient has also consumed alcohol.
Tegretol may be used alone or with other anticonvulsantsWhen added to existing anticonvulsant therapythe drug should be added gradually while the other anticonvulsants are maintained or gradually decreasedexcept phenytoinwhich may have to be increasedsee PRECAUTIONSDRUG INTERACTIONSand Pregnancy Category D
Tegretol has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizuresIt appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiationTegretol greatly reduces or abolishes pain induced by stimulation of the infraorbital nerve in cats and ratsIt depresses thalamic potential and bulbar and polysynaptic reflexesincluding the linguomandibular reflex in catsTegretol is chemically unrelated to other anticonvulsants or other drugs used to control the pain of trigeminal neuralgiaThe mechanism of action remains unknown.
Hepatic effectsranging from slight elevations in liver enzymes to rare cases of hepatic failure have been reportedsee ADVERSE REACTIONS and PRECAUTIONSLaboratory TestsIn some caseshepatic effects may progress despite discontinuation of the drugIn addition rare instances of vanishing bile duct syndrome have been reportedThis syndrome consists of a cholestatic process with a variable clinical course ranging from fulminant to indolentinvolving the destruction and disappearance of the intrahepatic bile ductsSomebut not allcases are associated with features that overlap with other immunoallergenic syndromes such as multiorgan hypersensitivityDRESS syndromeand serious dermatologic reactionsAs an example there has been a report of vanishing bile duct syndrome associated with Stevens-Johnson syndrome and in another case an association with fever and eosinophilia.
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