Epilepsy Flashcards
what antiepileptic drugs can be given once a day at bedtime?
LP3
- lamotrigine
- perampanel
- phenobarbital
- phenytoin
what drugs need to remain brand specific?
- carbamazepine
- primidone
- phenytoin
- phenobarbital
why do patients need to remain on the same brand
Differing bioavailability between different brands
category 2 drugs
need for continuity depeds on clinical judgement and consultation with patient/carer
what drugs are in category 2
- valproate
- topiromate
- clobazam
- clonazepam
- lamotrigine
category 3
no need for maintenance on brand specific except concerns for pt anxiety, risk of confusion or dosing errors
category 3 drugs
- levetiracetam
- gabapentin
- pregabalin
antiepileptic hypersensitivity syndrome
rare but potentially fatal syndrome associated with some epileptic drugs
what drugs are associated with antiepileptic hypersensitivity syndrome
- carbamazepine
- phenytoin
- phenobarbital
- primidone
cp3 + - rufinamide
- lamotrigine
- lacosamide
antiepileptic hypersensitivity syndrom symptoms
- usually start in the first 2 months of treatment
- fever
- rash
- liver dysfunction
- renal and pulmonary abnormalities
- multi organ failure
Antiepileptic MHRA safety alert
all antiepileptic drugs are associated with a small increased risk of suicidal thoughts and behaviour
driving
- if a driver has a seizure stop driving immediately and inform the DVLA
- patients with a first unprovoked epileptic seizure or a single isolated seizure stop driving for 6 months
- patients with established epilepsy may drive provided they are not a danger to public and compliant with treatment and follow up
- to continue driving, patients must be seizure free for at least 1 year. they must also not have a history of unprovoked seizures
- patient should. not drive during medication changes or withdrawal of antipileptic drugs and for 6 months after their last dose
what drugs need the patient to follow a PPP?
- valproate
- topiramate
tonic clonic seizure
- whole body stiffens (tonic)
- loss of consciousness
- convulsions due to uncontrollable muscle contractions (clonic)
TONIC- TIGHT
CLONIC- CONVULSIONS
absence seizures
- brief loss of consciousness and awareness for a few seconds
- no convulsion
- no falls
- lasts a few seconds
- mainly occurs in children
ABSENT FOR A SEC
myoclonic seizure
caused by a sudden contraction of the muscles, which causes a jerk
simple focal seixure
- may have muscular jerks or strange sensations in one arm or leg
- may develop an odd taste
pins and needles in one part of your body - no loss of consciousness or awareness
complex focal seizures
- depending on part of brain affected, behave strangely for a short period of time e.g. fiddle with an object, mumble, wander aimlessly
- conscioussness is affected
FOCAL IS CONSCIOUS
What counselling is needed in Lamotrigine
Immediately report any signs or symptoms of anaemia, bruising or infection to your doctor
what is the appropriate course of action for someone who has abdominal pain and is N&V on sodium valproate?
He should seek immediate medical attention, as the symptoms he describes may be indicative of sodium valproate-induced pancreatitis.
