Drug
name
|
MOA
|
Dose
mg\day
|
Adm.
|
S\E
|
Notes
|
Phenytoin
|
1
|
150-600
|
Orally after meals, IV in severe
attacks like st. epilepticus.
|
·
Gingival hyperplasia (interferes with collagen synthesis so can be
used externally in treatment of burns, wound, diabetes ulcers)
·
Decrease vit.B12 absorption (pernicious anemia).
·
Increase folic acid metabolism (megaloblastic anemia).
·
Increase Ca++ metabolism (osteomalacia).
·
Decrease ADH and insulin (hyperglycemia and glucosuria).
·
Hirsutism.
·
Teratogenic.
·
Hepatotoxic.
|
·
Causes fetal hydantoin syndrome (cleft lip, cleft palate, congenital
heart disease, mental deficiency).
·
It induces P-450 activity so increases metabolism of other drugs like
antiepileptics, anticoagulants, oral contraceptives, antibiotics and other agents.
|
Carbamazepine
|
1
|
200-2000
|
Orally, high lipid soluble
|
·
Osteomalacia.
·
Anemia.
·
Coma, respiratory
depression.
·
Vertigo, drowsiness,
ataxia, diplopia, nausea, vomiting.
·
Hepatotoxic.
|
·
It induces liver enzymes.
·
May be used as analgesic
in trigeminal neuroalagia and after tooth extraction.
|
Phnobarbitone
|
2
|
60-180
|
Oral
|
·
Sedation
·
Ataxia
·
Vertigo, hangover.
·
Behavior disturbances.
|
·
Sedative, anxiolytic
·
Enzyme inducers.
|
Primidone
|
2
|
250-1000
|
Oral
|
Metabolized into Phenobarbital,
has the same actions as Phenobarbital.
|
|
Valproic acid
|
2
|
400-3000
|
Oral
|
·
N,V, sedation, ataxia,
tremors.
·
Hepatotoxic.
·
Rash, alopecia.
·
Thrombocytopenia.
·
Weight gain.
|
·
Causes cleft lip.
|
Ethosuximide
|
1
|
500-1500
|
Orally
|
·
Dizziness, insomnia, agitation,
anxiety, inability to concentrate.
·
Irritation to stomach,
N,V.
·
Urticaria.
·
Leucopenia, aplastic
anemia, thrombocytopenia.
|
---
|
Benzodiazepines
|
·
orally
·
IV in severe attacks.
·
Rectally in febrile
seizure.
|
·
Tolerance.
·
Drowsiness, sedation,
fatigue, behavior disturbances.
·
Respiratory depression.
·
Cardiac depression with
IV adm.
|
·
Clonazepam and
Clorazepate are used for chronic treatment.
·
Diazepam for acute
attacks, and rectally for febrile epilepsy.
|
||
** Phenytoin, Phenobarbitone, Primidone cause vit. K
deficiency in new born leading to bleeding. (give vit. K injection)
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