Past Papers · SAQ

Valproate vs Carbamazepine

Current · V5 (2025) → H6.vi Historical · V4 (2023) → K2.iii 1 exam appearance

2015B Q24

Exam question

Compare and contrast the pharmacology of valproic acid and carbamazepine.

CICMWrecks answer

Master answer

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Field NA VALPROATE
Neurology & Sedation · Neurology & Sedation · Level 3
 CARBAMAZEPINE
Neurology & Sedation · Neurology & Sedation
Mechanism of action

Inhibits catabolism of γamino butyric acid(GABA) and inhibits voltage gated Na channels
- Increased [GABA] in neuronal junctions
- Increased Cl- conductance into neurons
- Neuronal hyperpolarization
- Increased threshold for depolarization
- Increased seizure threshold

Inhibits voltage gate Na channels
- Diffuses intracellularly and becomes
ionized
- Inhibits Na influx and therefore inhibits
depolarization
- Neurons become less excitable
Absorption

100% Oral bioavailability

100% Oral bioavailability
Protein binding

90% Protein binding,

80% Protein binding,
Volume of distribution

Vd 0.4l/kg

Vd 1l/kg
Metabolism

Hepatic β oxidation and conjugation

Hepatic phase 1 and 2
Excretion

Renal

Renal
Half-life

T1/2b 20 hours

T1/2b 24 hours
Class Group

Anticonvulsant

Anticonvulsant
Indications Uses

Anti-convulsant
Epilepsy

Anti-convulsant
Epilepsy
Schizophrenia
Trigeminal neuralgia
Legacy Cicm Level

Level 3

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Past papers

Exam appearances

1 appearance
Exam Exact exam wording Candidate success
2015B Q24 Compare and contrast the pharmacology of valproic acid and carbamazepine. 6%