general info Flashcards
dosage frequency is often determined by the …
plasma drug half life
the following 4 drugs have long half lives so can be given OD at bedtime
Lamotrigine, perampanel, phenobarbital, and phenytoin
change from one antiepileptic drug
should be cautious, slowly withdrawing the first drug only when the new regimen has been established
concurrent use of antiepileptic drugs increases
risk of adverse effects and drug interactions
what to do if combination therapy does not reduce seziures
revert to the regimen (monotherapy or combination therapy) that provided the best balance between tolerability and efficacy
aim of treatment
prevent the occurrence of seizures by maintaining an effective dose of one or more antiepileptic drugs (antiseizure medications)
MHRA antiepileptics risk of suicidal thoughts and behaviours
all antiepileptic drugs may be associated with a small increased risk of suicidal thoughts and behaviour; symptoms may occur as early as 1 week after starting treatment.
patients and their carers should be advised to seek medical advice if any mood changes, distressing thoughts, or feelings about suicide or self-harming develop, and that the patient should be referred for appropriate treatment if necessary.
Do you need to report any suspected adverse reactions to AEDs to Yellow Card?
yes
Category 1: ensure pt is maintained on specific manufacturers product
3Ps and 1C
carb, phenytoin, primidone, phenobarbital
Category 2: need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with the pt/carer taking into factors such as seizure freq, treatment Hx, potential implications to pt having a breakthrough seizure
Clobazam, clonazepam, eslicarbazepine acetate, lamotrigine, oxcarbazepine, perampanel, rufinamide, topiramate, valproate, zonisamide
what is antiepileptic hypersensitivity syndrome
rare but potentially fatal syndrome
associated with some AEDs (3Ps and C, lacosamide, lamot, oxcarbazepine, rufinamide); rarely cross-sensitivity occurs between some of these AEDs
how to remember which drugs are associated with antiepileptic hypersensitivity syndrome
3Ps and C + ROLL
Rufinamide, oxcarbazepine, lacosamide, lamotrigine
3Ps and C + ROLL
Rufinamide, oxcarbazepine, lacosamide, lamotrigine
how to remember which drugs are associated with antiepileptic hypersensitivity syndrome
these 3 drugs have a theoretical risk antiepileptic hypersensitivity syndrome
eslicarbazepine
stiripentol
zonisamide
when do symptoms of antiepileptic hypersensitivity syndrome usually start, and what are the most common symptoms
1-8 weeks of exposure
fever, rash, lymphadenopathy (swollen lymph nodes)