Epilepsy Drugs

Question 1

Phenytoin

Answer 1

PO,IV

Suppress Na+ influx

Side effect: harmless pink red urine

Dizziness, sedation, diplopia, nystagmus (avoid herbs, alcohol’

Dysrythmia, bradycardia, hypotension, syncope

Gingival hyperplasia ( frequent oral hygiene and dental check ups)

Hirsutism ( returns to normal when drug is discontinued )

Question 2

Phenytoin

Answer 2

PO: shake suspension for 2 min

IV: needs special IV tubing with inline filter ( purple glove syndrome )

Same time daily, do not discontinue abruptly

Dose adj is required to check in serum levels , it has a narrow therapeutic range (10-20 mcg/ml)

Decreased effect oral contraceptives, warfarin

Contraindication: pregnancy

Diabetics must monitor for hyperglycemia

Blood dryscrasia (abnormal cell size)

Stop if rash may develop Steven Johnson

Question 3

Suppress CA+ influx

Valporic acid

Answer 3

Dose adj is required

Check serum levels. Narrow therapeutic range is 50-150 mcg/ml.

Sideeffects/ adverse reactions: CNS effects,pancreatitis, thrombocytopenia

Contraindication: pregnancy, children less than 2 years

Question 4

Promote gaba release

Gabapentin

Answer 4

Secondary indication: neuropathies pain, restless leg syndrome, fibromyalgia (muscle and nerve pain ) , phantom pain ( pain in a part of the body you don’t have ),parasthesia

Side effects: drowsiness , dizziness, confusion,
Ataxia ( Balance ), angioedema ( swelling under the skin ) , Gi distress

Question 5

Cannabidiol oil (CBD)

Answer 5

Schedule 4 ( no risk of abuse)

Indication: two types of rare and severe epilepsy in pts 2 or older

Side effects: sleppiness, sedation , lethargy, liver failure , no euphoria , no psychoactive