phenobarbital

Question 1

indicated for all forms of epilepsy except

Answer 1

typical absence seizures

Question 2

what time to take dose

Answer 2

OD at night

Question 3

vitamin D supplementation

Answer 3

MHRA advises consider vitamin D supplementation in patients who are immobilised for long periods or who have inadequate sun exposure or dietary intake of calcium.

Question 4

can cause seizure exacerbation in pt with

Answer 4

absence seizures, Dravet syndrome, and Lennox-Gastaut syndrome.

Question 5

Antiepileptic hypersensitivity syndrome associated with phenobarbital?

Answer 5

yes

Question 6

use in BF and pregnancy

Answer 6

P: An increased risk of major congenital malformations and intra-uterine growth restriction, and possibility of adverse effects on neurodevelopment have been seen with phenobarbital

BF: avoid if possible, drowsiness may occur

Question 7

Therapeutic drug monitoring

Answer 7

Plasma-phenobarbital concentration for optimum response is 15–40 mg/litre (60–180 micromol/litre); however, monitoring the plasma-drug concentration is less useful than with other drugs because tolerance occurs.

Question 8

treatment cessation

Answer 8

Avoid abrupt withdrawal (dependence with prolonged use).