Lamotrigine

Question 1

Pre-drug work up for Lamotrigine?

Answer 1

LFTs, Scr, severe rash or Steven Johnson syndrome

Question 2

Interaction with Valproic acid and Tegretol?

Answer 2

VPA inhibits metabolism of LTG. leading to lamictal toxicity. It increases the elimination half-life of lamictal

Question 3

Drug interaction of Lamotrigine and carbamazepine, phenobarbital, phenytoin.

Answer 3

Induces metabolism of LTG. Result is reduced LTG efficacy

Question 4

Adverse effects of LTG?

Answer 4

Rash serious and nonserious, aseptic meningitis 40 cases in 15 years. Monitor for headache fever chills nausea vomiting stiff neck rash abnormal sensitivity to light drowsiness and confused
It is weight neutral

Question 5

Severe reaction with lamictal?

Answer 5

Serious life-threatening rash is requiring hospitalization

Question 6

When discontinuing lamictal it should be done?

Answer 6

Slowly because it may induce seizures

Question 7

Patients should monitor for blank when on the Lamictal?

Answer 7

Serious skin reactions such as Steven Johnson syndrome.
Also aseptic meningitis. Headache fever nausea vomiting stiff neck abnormal sensitive to the light chills confusion drowsiness

Question 8

What is Lamotrigine used for?

Answer 8

Bipolar, lennox – Gastaut syndrome, seizures

Question 9

Titration schedule

Answer 9

Week 1&2 25 mg
Week 3&4 50 mg
Week 5 100mg
Week 6 200 mg

Question 10

When using valproic acid and lamictal together you should?

Answer 10

Half the dose of lamictal starting dose to 12.5 mg. And go up to a target dose of 100 mg.

Question 11

If a patient stop Lamictal for a few days you should?

Answer 11

Restart dose titration

Question 12

Lamictal with carbamazepine, valproic, and phenytoin The dose should?

Answer 12

Be doubled to 50 mg initial, target dose of 400 mg

Question 13

Info

Answer 13

Patients receiving antiepiletics drugs had approximately twice the risk of suicidal behavior or ideation compared to placebo