EPILEPSY: OTHER AED DRUGS

Question 1

Ethosuximide - Indication

Answer 1

1. Absence
   * Adjunct in atypical
   * Myoclonic

Question 2

Ethosuximide - major side effect

Answer 2

Blood disorder

Question 3

Gabapentin - safety information

Answer 3

Levels of propylene glycol, acesulfame K and saccharin
sodium may exceed the recommended WHO daily
intake limits if high doses of gabapentin oral solution
(Rosemont brand) are given to adolescents or adults
with low body-weight (39–50 kg).

Question 4

Topiramate - indication

Answer 4

• T-C
• F
• Myo

Question 5

Topiramate - SEs

Answer 5

• Nausea
• Drowsiness
• Diarrhoea
• Altered mood
• Weight loss/decreased appetite

Question 6

Topiramate - other uses

Answer 6

Migraine prophylaxis

Question 7

Topiramate - cautions

Answer 7

• Acute porphyrias
• Risk of metabolic acidosis
• Risk of nephrolithiasis (kidney stones)

Question 8

Topiramate - preventing kidney stones

Answer 8

• Adequate hydration

Question 9

Topiramate - important side effect

Answer 9

• Acute myopia (short-sightedness) with secondary angle-closure glaucoma.
• 1 month of starting treatment.
• Fluid build-up resulting in anterior displacement of the lens and iris has also been reported.

Question 10

Topiramate - raise intraocular pressure

Answer 10

Seek specialist ophthalmological advice.
Appropriate measures to reduce intra-ocular pressure.
Stop topiramate as rapidly as feasible.

Question 11

Topiramate - contraception

Answer 11

PPP
* increased risk of autism, ADHD and intellectual disability

Question 12

Can topiramate be taken during pregnancy?

Answer 12

• If for migraine prophylaxis, then no
• If epilepsy, then yes if no other option
• Extra monitoring required e.g. fetal growth

Question 13

Can you take
topiramate whilst breastfeeding?

Answer 13

• Yes
• Monitor ADRs in children

Question 14

Vigabatrin - indication

Answer 14

• Focal - not controlled by other drugs
• Expert only

Question 15

Vigabatrin - SE

Answer 15

Visual field effects
Encephalopathic symptoms - sedation confusion

Question 16

Benzodiazepines

Answer 16

Should only be administered by or under direct supervision of an experienced personnel with adequate training in anaesthesia and airway management.

Question 17

Zonisamide - indications

Answer 17

Focal

Question 18

Zonisamide - SEs

Answer 18

• Appetite decreased
• Weight decreased
• Drowsiness (increased sleeping)
• Speech disorder

Question 19

Zonisamide - contraception

Answer 19

Women of child-bearing age should be on contraception
They should be counselled on risk of Zonisamide during pregnancy

Question 20

Zonisamide in children, what should you be aware of?

Answer 20

• avoid factors that cause overheating and dehydration e.g. hot weather, exercise
• Cases of heat stroke previously reported