ANTICONVULSANT THERAPY
MECHANISM OF ACTION
PREVENT EXCESSIVE DISCHARGE OF ABNORMAL NEURONS
- PREVENT DISCHARGE OF NORMAL NEURONS ADJACENT TO ABNORMAL AREA
- RAISE THRESHOLD OF STIMULATION
- ACTIVATE INHIBITORY PATHWAYS
PHENYTOIN
THERAPEUTIC USE
generalize non-convulsive seizures (petit mal)
febrile seizures
generalized convulsive seizures (gran mal)
seizures following withdrawal of short acting barbiturates
digoxin toxicity arrhythmias
PHENYTOIN SIDE EFFECTS
HYPERPLASIA OF GUMS
DERMATITIS
HIRSUITISM
GI UPSET
SEDATION - tolerance develops to this side effect
PHENYTOIN
Toxicities
Nystagmus is early sign
Food/Drug Interaction
Folic acid supplementation may be needed
BARBITURATES
Primidone is converted to phenobarbital
Febrile seizures
Convulsant seizures
Barbiturate withdrawal seizures
BARBITURATE PROPERTIES
Side effects - sedation
Hepatic Induction - stimulates metabolism of other agents including other anticonvulsant agents
ETHOSUXIMIDE
Therapeutic Use
General non-convulsant seizures (petit mal)
Side Effects
sedation
headache
dizziness
DIVALPROEX
Therapeutic Use
Febrile Seizures
Non-convulsant seizures
Convulsant Seizures
Side Effects
Sedation
BENZODIAZEPINES
CLONAZEPAM
Always used as adjunct therapy only
Tolerance develops to therapeutic properties
LORAZEPAM/DIAZEPAM
Intravenous use for status epilepticus
CARBAMAZEPINE
THERAPEUTIC USE
Partial Seizures
Neurologic Pain
TOXICITY
Bone marrow depression
MISCELLANEOUS
FOSPHENYTOIN - intravenous administration of phenytoin
Adjunct therapy for partial seizures
Neurologic Pain