Epilepsy drug toxicities

Question 1

Benzodiazepines

Answer 1

Sedation, tolerance, dependence.

Notes:
Stevens-Johnson syndrome - prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing.

Question 2

Carbamazepine

Answer 2

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P-450, SIADH, Stevens-Johnson syndrome.

Notes:
Stevens-Johnson syndrome - prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing.

Question 3

Ethosuximide

Answer 3

GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome.

Notes:
EFGH - Ethosuximide, Fatigue, GI, Headache.

Question 4

Phenobarbital

Answer 4

Sedation, tolerance, dependence, induction of cytochrome P-450.

Question 5

Phenytoin

Answer 5

Nystagmus, diplopia, ataxia, sedation gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome P-450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia.

Question 6

Valproic acid

Answer 6

GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain. Contraindicated in pregnancy.

Question 7

Lamotrigine

Answer 7

Steven-Johnson syndrome.

Question 8

Gabapentin

Answer 8

Sedation, ataxia.

Question 9

Topiramate

Answer 9

Sedation, mental dulling, kidney stones, weight loss.