A/E

Question 1

A/E of phenytoin

Answer 1

Dose dependent toxicity
2 triple H = 6H
1.Hypertophy and hyperplasia of gums(due to collagen catabolism) seen in chronic therapy

2. Hypersensitivity reaction - skin rash,neutropenia,rarely Hepatotoxicity

3.Hirautism- due to ↑ androgen secretion

4.Hyperglycaemic- due to ↑ insulin

5.Hypocalcemia - ↓ Ca++ absorption

6.fetal Hydantoin syndrome - cleft lip,cleft palate, digital hypoplasia

7. Megaloblastic anaemia- folate def.

8.osteomalacia- ↑ metabolism of VitD

High concentration -
CNS: vestibulocerebellar syndrome - nastagmus,vertigo,ataxia,Tremor,headache

CVS: hypotension and cardiac arrhythmia on i.v.

GIT: n,v,dyspepsia - minimised by giving phenytoin after food

Damage to intima of vein in i.v.

Question 2

A/E of carbamazepine

Answer 2

Sedation
Vertigo
Ataxia
Blurred vision
Confusion
Hypersensitivity rx - rashes, eosinophilia, lymphadenopathy,hepatitis

Rare,-
BM depression
NeutroPenia-
Aplastic anemia
Agranulocytosis

On chronic therapy - water retention (due to ↑ ADH)

Question 3

A/E of phenobarbitone

Answer 3

Sedation
Tolerance
Nystagmus,ataxia, confusion, megaloblastic anemia,skin rashes

Chronic therapy
Impaired behaviour and memory in children

Question 4

A/E of valproic acid

Answer 4

VALPROATE

V- vomiting

A- anorexia, alopecia , curling of hair

L-liver( fulminant Hepatitis) avoid in child< 3yr

P- pancreatitis

R- rashes

O- orofacial and digital abnormalities
T- teratogenic - above + neural tube defect ↑ risk of spina bifida

E-elevation of liver enzymes

Question 5

A/E of diazepam

Answer 5

Hypotension
Resp. Depression
Clonazepam -Sedation, lethargy

Chronic therapy - tolerance

Other - hypotonia
Dysarthria
Dizziness
Behavioural disturbance - irritability, hyperactivity,loss of concentration