IC7- ADEs of ASMs and Monitoring

Question 1

ADEs of carbamazepine?

Answer 1

ADEs
Common:
- Nystagmus
- N/V
- Lethargy
- Dizziness
- Drowsiness
- Headache
- Blurred vision
- Diplopia
- Unsteadiness
- Ataxia
- Incoordination
Others:
- *Hyponatremia, neutropenia leukopenia, aplastic anaemia, rash, SJS, hepatotoxicity, *osteopenia/ osteoporosis, neuropathy

Question 2

Monitoring for carbamazepine?

Answer 2

Monitor for:
- Osteopenia/ osteoporosis
- Lipids (cholesterol, LDL)
- Serum sodium levels

Question 3

ADEs of phenytoin?

Answer 3

ADEs
Common (exactly same as CBZ):
- Nystagmus
- N/V
- Lethargy
- Dizziness
- Drowsiness
- Headache
- Blurred vision
- Diplopia
- Unsteadiness
- Ataxia
- Incoordination
Others:
- *Gingival hyperplasia, *hirsutism, neuropathy, dyskinesia, macrocytic anaemia, blood dyscrasias, *osteoporosis, hepatotoxicity, rash, SJS

Question 4

Monitoring for phenytoin?

Answer 4

Monitor for:
- Osteopenia/ osteoporosis
- Lipids (cholesterol, LDL)

Question 5

ADEs of valproate?

Answer 5

ADEs
Common:
- N/V
- *Weight gain
- Ataxia
- Tremor
Others:
- Hepatotoxicity, *thrombocytopenia, neutropenia, pancreatitis, alopecia, hyperammonemia, osteopenia/ osteoporosis

Question 6

ADEs of phenobarbital?

Answer 6

ADEs
Common:
- Sedation
- Drowsiness
Others:
- Dysarthria, ataxia, incoordination, nystagmus

Question 6

Monitoring for valproate?

Answer 6

Monitor for:
- Osteopenia/ osteoporosis
- Platelet counts
- LFTs

Question 7

ADEs of levetiracetam?

Answer 7

ADEs
Common:
- Somnolence
- Dizziness
- Asthenia
- Coordination difficulties (‼️ESP first 4w of initiation)
- Headache
Others:
- Irritability, aggression, behavioural disturbances

Question 8

ADEs of lamotrigine?

Answer 8

ADEs
Common:
- Dizziness
- N/V
- Headache
- Incoordination
- Tremor
- Somnolence
- Asthenia
- Headache
Others:
- Rash, SJS/TEN, DRESS

Question 9

ADEs of topiramate?

Answer 9

ADEs
Common:
- Somnolence
- Ataxia
- Fatigue
- Cognitive dysfunction (psychomotor slowing, speech, memory)
- Weight loss
- Nausea
Others:
- Glaucoma, hyperammonemia, metabolic acidosis, hyperthermia (oligohidrosis), paresthesias, renal stones

Question 10

ADEs of pregabalin and gabapentin?

Answer 10

ADEs
Common:
- Drowsiness
- Ataxia
- *Weight gain
- Dizziness
Others:
- *Peripheral edema