Antiepileptic Drugs

by Carlo Raj, MD

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    So what is your goal in terms of management of your patient with epilepsy? Goal of drug therapy is so that you become seizure-free or at least, to limit the seizures because, remember, the Lennox Gastault, say that your child is having 200 seizures per day, huh? At this point, your first step – your first priority is, my goodness, minimize the number of seizures. Did you become free of seizures? Well, it’s all case dependent, isn’t it? And you want minimal side effects. And that’s a big deal with antiepileptic drugs as we shall see. Monotherapy is always preferred because the more number of antiepileptic drugs that you’re on, the cocktails will then bring about more risk for adverse effects. Most patients could be controlled with one drug, thank goodness. Treatment is generally indicated after a second unprovoked seizure because after that first one, it could be a trigger of seizure, a second that’s unprovoked, then you start thinking about management. Medications should not be stopped abruptly ever -- ever-- unless absolutely necessary due to the serious side effect that the patient might be experiencing. Let’s talk about the drugs. We’ll begin with phenytoin, Dilantin. So what does this behave like? Well, you should remember that this behaves like a sodium channel blocker, specifically, the inactivation gate. It kind of behaves like lidocaine, okay? But you can’t use lidocaine here. Use phenytoin. By blocking the sodium channel, hopefully , hopefully, hopefully, you’ll be able to decrease the depolarization. What are the types of seizures that you’re looking for primarily? Well, seizure type here for phenytoin, definitely focal. Focal. So either simple partial or complex partial. Generalized could be used but your focus, please, should be on partial or focal, same thing. Let’s talk about the side effects. Many of...

    About the Lecture

    The lecture Antiepileptic Drugs by Carlo Raj, MD is from the course Seizures.

    Included Quiz Questions

    1. Phenytoin
    2. Carbamazepine
    3. Valproic acid
    4. Phenobarbital
    5. Gabapentin
    1. Carbamazepine
    2. Phenytoin
    3. Valproic acid
    4. Phenobarbital
    5. Gabapentin
    1. Early closure and fusion of frontal bones of skull
    2. Delayed closure and fusion of frontal bones of skull
    3. Improper mineralization of frontal bones of skull
    4. Enlarged fontanelle
    5. Absence of formation of skull cap
    1. Thalamus
    2. Cerebellum
    3. Medulla
    4. Pituitary gland
    5. Hypothalamus
    1. Polymerase gamma
    2. Polymerase alpha
    3. Polymerase beta
    4. Polymerase kappa
    5. Polymerase zeta

    Author of lecture Antiepileptic Drugs

     Carlo Raj, MD

    Carlo Raj, MD

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