Review of Anticonvulsant Medications: Traditional and Alternative Uses. Andrea Michel, PharmD, CACP
|
|
- Linette Phelps
- 5 years ago
- Views:
Transcription
1 Review of Anticonvulsant Medications: Traditional and Alternative Uses Andrea Michel, PharmD, CACP
2 Objectives Review epidemiology of epilepsy Classify types of seizures Discuss non-pharmacologic and pharmacologic treatment options for epilepsy Outline common adverse reactions and prevalent drug-drug interactions associated with anticonvulsant medications Highlight important considerations for special patient populations with epilepsy State appropriate plan for anticonvulsant medication therapy discontinuation
3 Epilepsy
4 Definition Central nervous system disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness Epilepsy diagnosis requires: History of >2 seizures at least 24 hours apart OR 1 seizure with significant risk of recurrence (e.g. recent stroke, brain structure abnormality, abnormal electroencephalography (EEG))
5 Prevalence in the US 3 Million adults & 470,ooo children 1.2% of population Epidemiology CDC: Epilepsy Data and Statistics. Accessed 9/
6 Causes Mechanical birth injuries, head trauma, tumors, stroke Metabolic electrolyte disturbances, hypoglycemia Genetic Influence familial neonatal seizures, juvenile myoclonic epilepsy (JME) Other fever, infectious disease
7 Causes Drugs Recreational drugs Carbapenems Meperidine Local anesthetics Metoclopramide Theophylline Tricyclic antidepressants Anticonvulsant therapy: carbamazepine, phenytoin, phenobarbital
8 Diagnosis Medical History Physical and Neurological Exam Lab tests Electroencephalogram (EEG) Magnetic resonance imaging (MRI)
9 Classification of Seizures
10 Focal seizure Focal Seizure One hemisphere of the brain Unilateral, asymmetric movements Associated with an aura Other terms: simple partial seizure, complex partial seizure, secondarily generalized seizure
11 Generalized seizure Generalized seizure Begins simultaneously in both brain hemispheres Types of generalized seizures: 1. Absence 2. Myoclonic 3. Tonic-clonic 4. Clonic 5. Tonic 6. Atonic
12 Unknown onset seizure Unknown seizure Reserved for seizures that are unwitnessed Occur while patient is asleep Observers cannot provide an adequate description
13 Status epilepticus Status Epilepticus Seizure that lasts >20 minutes OR >2 seizures with incomplete recovery of consciousness between episodes Medical emergency Up to 20% mortality rate
14 Treatment of Epilepsy
15 Treatment Non-Pharmacologic Surgical Procedures Vagus Nerve Stimulation Dietary Restrictions Pharmacologic Anticonvulsant medication therapy
16 Anticonvulsant Therapy
17 Treatment algorithm DiPiro JT, Talbert RL, Yee GC, et al, eds. Pharmacotherapy: A Pathophysiologic Approach, 9 th ed. Figure 40-1.
18 First Line Treatment of New-Onset Epilepsy for Patients > 13YO National Institute for Health and Care Excellence (NICE). Epilepsies: Diagnosis and Management. Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
19 Adverse Effects Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
20 Adverse Effects Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I:: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
21 Adverse Effects Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
22 Drug Selection Serious adverse effects rapid discontinuation required Drug reaction with eosinophilia and system symptoms (DRESS) Stevens-Johnson syndrome (SJS) Toxic epidermal necrolysis (TEN)
23 Pharmacogenomic Considerations Drug Selection Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
24 Drug Selection Drug Interactions!
25 Metabolism and Monitoring Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
26 Metabolism and Monitoring Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
27 Interactions of Non-AEDs Ryan, M. Neurology: ACCP Updates in Therapeutics 2013: The Pharmacotherapy Review and Recertification Course. Lenexa, KS. 2013:
28 Interactions of Non-AEDs Ryan, M. Neurology: ACCP Updates in Therapeutics 2013: The Pharmacotherapy Review and Recertification Course. Lenexa, KS. 2013:
29 Interactions of Non-AEDs Ryan, M. Neurology: ACCP Updates in Therapeutics 2013: The Pharmacotherapy Review and Recertification Course. Lenexa, KS. 2013:
30 Drug Selection Alternative indications Mood stabilization related to bipolar disorder: valproate, carbamazepine, and lamotrigine Neuropathic pain & postherpetic neuralgia: gabapentin and pregabalin Migraine prophylaxis: valproate and topiramate Essential tremor: primidone Trigeminal neuralgia: carbamazepine Anxiety: phenobarbital
31 Adjunct Therapy Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. Neurology Jul 2018;81:74-81.
32 Adjunct Therapy Ryan, M. Neurology: ACCP Updates in Therapeutics 2013: The Pharmacotherapy Review and Recertification Course. Lenexa, KS. 2013:
33 Special Populations
34 Elderly Pharmacokinetic changes in aging population may affect therapy 1. Carbamazepine: Decreased clearance 2. Phenytoin: Decreased protein binding if renal failure or hypoalbuminemic 3. Valproic acid: Decreased protein binding 4. Diazepam: Increased half-life 5. Lamotrigine: Decreased clearance 6. Seizure medications with renal elimination must be adjusted based on CrCl
35 Women s Health Reproductive years: Match best drug for seizure type Monotherapy, if possible Discuss possible decrease in hormonal contraceptive effectiveness if appropriate Ideal to be seizure free for at least 9 months before pregnancy Folic acid 1 mg daily
36 Women s Health During pregnancy: Avoid valproic acid monotherapy or polytherapy during 1st trimester Avoid use of seizure medication polytherapy throughout complete pregnancy Avoid use of phenytoin, carbamazepine, and phenobarbital, if possible Lamotrigine has a lower relative risk of congenital malformations
37 Treatment discontinuation
38 Treatment discontinuation Consider withdrawal of anticonvulsants: Remain seizure-free for 2 or more years Control obtained with 1 drug Normal neurologic examination EEG normalized with seizure medication treatment No history of seizure relapse after drug withdrawal Withdraw 1 drug at a time Taper over several months Common regimen: reduce the dose by 1/3 for 1 month, reduce by another 1/3 for 1 month, and then stop
39 Other Considerations
40 Sexual Dysfunction Reported in 30-60% of men and women with epilepsy Mechanism: Induction of CYP isoenzymes to increase testosterone metabolism Increased hepatic synthesis of sex hormone-binding globulin Induction of aromatase; conversion to testosterone and estradiol Dysfunction associated with: carbamazepine, phenobarbital, phenytoin, pregabalin, topiramate, zonisamide Improved functioning with: lamotrigine and oxcarbazepine
41 Bone Health Osteopenia and osteoporosis reported in 38-60% in tertiary epilepsy clinics Increased risk based on treatment duration Evidence that all seizure medications likely contribute Treatment: Vitamin D (4000 IU/day for adults and 2000 IU/day for children)
42 Twice the risk of suicidal behavior or ideation for patients receiving seizure medications No difference between type of antiepileptic drug or age group Suicidality In 2008, FDA required warning and medication guide for all seizure medications
43 Questions?
Prescribing and Monitoring Anti-Epileptic Drugs
Prescribing and Monitoring Anti-Epileptic Drugs Mark Granner, MD Clinical Professor and Vice Chair for Clinical Programs Director, Iowa Comprehensive Epilepsy Program Department of Neurology University
More informationEpilepsy and EEG in Clinical Practice
Mayo School of Professional Development Epilepsy and EEG in Clinical Practice November 10-12, 2016 Hard Rock Hotel at Universal Orlando Orlando, FL Course Directors Jeffrey Britton, MD and William Tatum,
More informationChapter 31-Epilepsy 1. public accountant, and has begun treatment with lamotrigine. In which of the following activities
Chapter 31-Epilepsy 1 Chapter 31. Epilepsy, Self-Assessment Questions 1. BW is a 28-year-old man recently diagnosed with partial seizures. He works as a certified public accountant, and has begun treatment
More informationAnticonvulsants Antiseizure
Anticonvulsants Antiseizure Seizure disorders Head trauma Stroke Drugs (overdose, withdrawal) Brain tumor Encephalitis/ Meningitis High fever Hypoglycemia Hypocalcemia Hypoxia genetic factors Epileptic
More informationEpilepsy 7/28/09! Definitions. Classification of epilepsy. Epidemiology of Seizures and Epilepsy. International classification of epilepsies
Definitions Epilepsy Dr.Yotin Chinvarun M.D., Ph.D. Seizure: the clinical manifestation of an abnormal and excessive excitation of a population of cortical neurons Epilepsy: a tendency toward recurrent
More informationManagement of Epilepsy in Primary Care and the Community. Carrie Burke, Epilepsy Specialist Nurse
Management of Epilepsy in Primary Care and the Community Carrie Burke, Epilepsy Specialist Nurse Epilepsy & Seizures Epilepsy is a common neurological disorder characterised by recurring seizures (NICE,
More informationIntroduction. 1 person in 20 will have an epileptic seizure at some time in their life
Introduction 1 person in 20 will have an epileptic seizure at some time in their life Epilepsy is diagnosed on the basis of two or more epileptic seizures. Around 450,000 people in the UK have epilepsy
More informationElements for a public summary. VI.2.1 Overview of disease epidemiology
VI.2 Elements for a public summary VI.2.1 Overview of disease epidemiology Epilepsy: It is the commonest neurological condition, characterized by recurrent seizures, affecting people of all ages, race
More informationErnie Somerville Prince of Wales Hospital EPILEPSY
Ernie Somerville Prince of Wales Hospital EPILEPSY Overview Classification New and old anti-epileptic drugs (AEDs) Neuropsychiatric side-effects Limbic encephalitis Non-drug therapies Therapeutic wishlist
More informationIn our patients the cause of seizures can be broadly divided into structural and systemic causes.
Guidelines for the management of Seizures Amalgamation and update of previous policies 7 (Seizure guidelines, ND, 2015) and 9 (Status epilepticus, KJ, 2011) Seizures can occur in up to 15% of the Palliative
More informationZONISAMIDE THERAPEUTICS. Brands * Zonegran. Generic? Not in US. If It Doesn t Work * Class Antiepileptic drug (AED), structurally a sulfonamide
Z:/3-PAGINATION/SBT/2-PROOFS/NWMS/9780521136723C111//9780521136723C111.3D 376 [376 380] ZONISAMIDE Brands Zonegran Generic? Not in US THERAPEUTICS Class Antiepileptic drug (AED), structurally a sulfonamide
More informationTOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER)
divalproex sodium TOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER) Pharmacodynamics study of what a drug does to the body Divalproex sodium is chemically compounded from sodium valproate and
More informationWhen choosing an antiepileptic ... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs. Based on a presentation by Barry E.
... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs Based on a presentation by Barry E. Gidal, PharmD Presentation Summary A physician s choice of an antiepileptic drug (AED) usually depends
More informationDoes a diagnosis of epilepsy commit patients to lifelong therapy? Not always. Here s how to taper AEDs safely and avoid relapse.
Does a diagnosis of epilepsy commit patients to lifelong therapy? Not always. Here s how to taper AEDs safely and avoid relapse. T he epilepsy specialist always has two equally important endpoints in mind
More informationObjectives / Learning Targets: The learner who successfully completes this lesson will be able to demonstrate understanding of the following concepts:
Boone County Fire District EMS Education-Paramedic Program EMS 270 Medical Cases-Seizures Resources Seizures screencast Seizures Flowchart and Seizures Flowchart Video Explanation Objectives / Learning
More informationPregnancy. General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition)
Pregnancy General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition) In all women of child bearing potential Always discuss the possibility of pregnancy; half of all pregnancies are unplanned
More informationSee 17 for PATIENT COUNSELING INFORMATION and Medication Guide. Revised: 11/2011
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use LAMICTAL safely and effectively. See full prescribing information for LAMICTAL. LAMICTAL (lamotrigine)
More informationDOSAGE FORMS AND STRENGTHS Tablets: 25 mg, 100 mg, 150 mg, and 200 mg; scored. (3.1, 16)
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use LAMOTRIGINE TABLETS safely and effectively. See full prescribing information for LAMOTRIGINE TABLETS.
More informationEPILEPSY DIAGNOSIS. Investigations- EEG, MRI, CT, blood tests. Appendix 1 contains a guide to questions to help with diagnosis
EPILEPSY DIAGNOSIS All adults with a recent-onset suspected seizure should be seen urgently by a specialist. The seizure type(s) and epilepsy syndrome, aetiology and co-morbidity should be determined.
More information11/7/2018 EPILEPSY UPDATE. Dr.Ram Sankaraneni. Disclosures. Speaker bureau LivaNova
EPILEPSY UPDATE Dr.Ram Sankaraneni Disclosures Speaker bureau LivaNova 1 Outline New onset Seizure Investigations in patients with epilepsy Medical management of epilepsy Non Pharmacological options in
More informationObjectives. Amanda Diamond, MD
Amanda Diamond, MD Objectives Recognize symptoms suggestive of seizure and what those clinical symptoms represent Understand classification of epilepsy and why this is important Identify the appropriate
More information1/31/2009. Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function
Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function In epilepsy abnormal neurons undergo spontaneous firing Cause of abnormal firing is unclear Firing spreads
More informationUpdated advice for nurses who care for patients with epilepsy
NICE BULLETIN Updated advice for nurses who care for patients with epilepsy NICE provided the content for this booklet which is independent of any company or product advertised NICE BULLETIN Updated advice
More informationRECENT MAJOR CHANGES Warnings and Precautions, Hemophagocytic
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use LAMICTAL safely and effectively. See full prescribing information for LAMICTAL. LAMICTAL (lamotrigine)
More informationEpilepsy is a very individualized
... PRESENTATION... Treatment of Epilepsy in 3 Specialized Populations Based on a presentation by Ilo E. Leppik, MD Presentation Summary When discussing the treatment of epilepsy, targeted populations
More informationManagement of Epilepsy in Pregnancy
Management of Epilepsy in Pregnancy September 7, 2018 Stephanie Paolini, MD Clinical Instructor/Women s Neurology Fellow UPMC Neurology We ve come a long way Sterilization of people with epilepsy was legal
More informationAMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY, INC. SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE
SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE 2014 Content Blueprint (November 26, 2012) Number of questions: 200 I. Classification 7 9% II. Routine EEG 16 20% III. Evaluation 22 26% IV.
More informationEpilepsy 101. Russell P. Saneto, DO, PhD. Seattle Children s Hospital/University of Washington November 2011
Epilepsy 101 Russell P. Saneto, DO, PhD Seattle Children s Hospital/University of Washington November 2011 Specific Aims How do we define epilepsy? Do seizures equal epilepsy? What are seizures? Seizure
More informationEpilepsy: pharmacological treatment by seizure type. Clinical audit tool. Implementing NICE guidance
Epilepsy: pharmacological treatment by seizure type Clinical audit tool Implementing NICE guidance 2012 NICE clinical guideline 137 Clinical audit tool: Epilepsy (2012) Page 1 of 25 This clinical audit
More informationEpilepsy 101. Overview of Treatment Kathryn A. O Hara RN. American Epilepsy Society
Epilepsy 101 Overview of Treatment Kathryn A. O Hara RN American Epilepsy Society Objectives Describe the main treatment options for epilepsy Identify factors essential in the selection of appropriate
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Absence seizures, 6 in childhood, 95 Adults, seizures and status epilepticus in, management of, 34 35 with first-time seizures. See Seizure(s),
More information2011 MNA Midwest Summer Conference
2011 MNA Midwest Summer Conference Women and Epilepsy Marianna V. Spanaki, M.D., Ph.D., M.B.A. SENIOR STAFF NEUROLOGIST DIRECTOR EPILEPSY MONITORING UNIT HENRY FORD COMPREHENSIVE EPILEPSY PROGRAM HENRY
More informationMedications for Epilepsy What I Need to Know
Medications for Epilepsy What I Need to Know Safiya Ladak, BSc.Phm. Toronto Western Hospital, UHN Clinical Pharmacist, Neurology and Neurosurgery June 4, 2016 Learning Objectives Treatment options for
More informationEpilepsy T.I.A. Cataplexy. Nonepileptic seizure. syncope. Dystonia. Epilepsy & other attack disorders Overview
: Clinical presentation and management Markus Reuber Professor of Clinical Neurology Academic Neurology Unit University of Sheffield, Royal Hallamshire Hospital. Is it epilepsy? Overview Common attack
More informationThere are several types of epilepsy. Each of them have different causes, symptoms and treatment.
1 EPILEPSY Epilepsy is a group of neurological diseases where the nerve cell activity in the brain is disrupted, causing seizures of unusual sensations, behavior and sometimes loss of consciousness. Epileptic
More informationSee 17 for PATIENT COUNSELING INFORMATION and Medication Guide. Revised: May 2009 LMT:2PI
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use LAMICTAL safely and effectively. See full prescribing information for LAMICTAL. LAMICTAL (lamotrigine)
More informationEpilepsy and Epileptic Seizures
Epilepsy and Epileptic Seizures Petr Marusič Dpt. of Neurology Charles University, Second Faculty of Medicine Motol University Hospital Diagnosis Steps Differentiation of nonepileptic events Seizure classification
More informationIs it epilepsy? Does the patient need long-term therapy?
Is it a seizure? Definition Transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain Is it provoked or unprovoked? Is it epilepsy? Does the
More informationDisclosure. Learning Objectives
Linda D. Leary, M.D. Associate Clinical Professor of Pediatrics & Neurology South Texas Comprehensive Epilepsy Center UT Health Science Center San Antonio Disclosure Linda D. Leary, M.D. discloses the
More informationDiagnosing Epilepsy in Children and Adolescents
2019 Annual Epilepsy Pediatric Patient Care Conference Diagnosing Epilepsy in Children and Adolescents Korwyn Williams, MD, PhD Staff Epileptologist, BNI at PCH Clinical Assistant Professor, Department
More informationEPILEPSY: SPECTRUM OF CHANGE WITH AGE. Gail D. Anderson, Ph.D.
EPILEPSY: SPECTRUM OF CHANGE WITH AGE Gail D. Anderson, Ph.D. Incidence: 0.5% - 1.0% of U.S. population Peak incidence of onset: first 2 years of life, ages 5-7 years, early puberty and elderly. 125,000
More informationLAMICTAL GlaxoSmithKline
LAMICTAL GlaxoSmithKline Lamotrigine QUALITATIVE AND QUANTITATIVE COMPOSITION Tablets: LAMICTAL, 25, 50, 100 and 200 mg. Dispersible/Chewable Tablets: LAMICTAL, 2, 5, 25, 50, 100 and 200 mg. PHARMACEUTICAL
More informationSUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE Content Blueprint (December 21, 2015)
SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE 2016 Content Blueprint (December 21, 2015) Number of questions: 200 1. Classification 8-12% 2. Routine EEG 16-20% 3. Evaluation 23-27% 4. Management
More informationContemporary Developments in Childhood Epilepsy Management. Olivia O Mahony, Cork University Hospital, Cork, and Mercy University Hospital
Contemporary Developments in Childhood Epilepsy Management Olivia O Mahony, Cork University Hospital, Cork, and Mercy University Hospital Developments in Epilepsy Care Standardised epilepsy care using
More informationLAMICTAL XR (lamotrigine) extended-release tablets, for oral use Initial U.S. Approval: 1994
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use LAMICTAL XR safely and effectively. See full prescribing information for LAMICTAL XR. LAMICTAL XR
More informationChapter 15. Media Directory. Convulsion. Seizures. Epilepsy. Known Causes of Seizures. Drugs for Seizures
Chapter 15 Drugs for Seizures Slide 43 Slide 45 Media Directory Diazepam Animation Valproic Acid Animation Upper Saddle River, New Jersey 07458 All rights reserved. Seizures Convulsion Abnormal or uncontrolled
More informationAntiepileptics. Medications Comment Quantity Limit Carbamazepine. May be subject Preferred to quantity limit Epitol
Market DC Antiepileptics Override(s) Approval Duration Prior Authorization 1 year Step Therapy Quantity Limit *Indiana Medicaid See State Specific Mandate below *Maryland Medicaid See State Specific Mandate
More informationSEIZURES PHARMACOLOGY. University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D
SEIZURES PHARMACOLOGY University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D 1 Understand the pharmacodynamics involved in the medications used to treat seizures
More informationMeasures have been taken, by the Utah Department of Health, Bureau of Health Promotions, to ensure no conflict of interest in this activity
Measures have been taken, by the Utah Department of Health, Bureau of Health Promotions, to ensure no conflict of interest in this activity Seizures in the School Setting Meghan Candee, MD MS Assistant
More informationInitial Treatment of Seizures in Childhood
Initial Treatment of Seizures in Childhood Roderic L. Smith, MD, Ph.D. Pediatric Neurology Clinic of Alaska,PC Incidence of Seizures Overall 5% by age 20 yrs. Lifetime risk= 5-10% CNS Infections= 5% TBI=10%
More informationOpinion 24 July 2013
The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 24 July 2013 FYCOMPA 2 mg, film-coated tablet B/7 (CIP: 34009 267 760 0 8) B/28 (CIP: 34009 268 447 4 5) FYCOMPA 4
More informationTreatment of epilepsy in adults
Treatment of epilepsy in adults Review 33 Treatment of epilepsy in adults S B Gunatilake 1, A Arasalingam 2 Sri Lanka Journal of Neurology, 2012, 1, 33-38 Case vignettes 1. A 60-year old patient with long
More informationLamotrigine 2 mg, 5 mg, 25 mg, 50 mg, 100 mg, 200 mg dispersible/chewable tablets
Arrow - Lamotrigine Lamotrigine 2 mg, 5 mg, 25 mg, 50 mg, 100 mg, 200 mg dispersible/chewable tablets Presentation Arrow - Lamotrigine 2 mg White to off-white, round tablets embossed with 'LI' over '2'
More informationManagement of Epilepsy In Primary Care Practice. Video Examples. Talk Like a Neurologist: Seizure Types
Management of Epilepsy In Primary Care Practice S. Andrew Josephson MD Carmen Castro Franceschi and Gladyne K. Mitchell Neurohospitalist Distinguished Professor Vice Chairman, Department of Neurology Director,
More informationJeffrey W Boyle, MD, PhD Avera Medical Group Neurology Sioux Falls, SD
Jeffrey W Boyle, MD, PhD Avera Medical Group Neurology Sioux Falls, SD Disclosures: None Objectives Recognize the incidence of seizure and epilepsy in the US population Appreciate the differences in seizure
More informationChapter 15. Seizures. Learning Objectives. Learning Objectives 9/11/2012
Chapter 15 Seizures Learning Objectives Demonstrate proper procedure for rectal administration of diazepam, and discuss why rectal administration is sometimes necessary for patient having a seizure Discuss
More informationTypes of epilepsy. 1)Generalized type: seizure activity involve the whole brain, it is divided into:
Types of epilepsy We have different types of epilepsy, so it is not one type of seizures that the patient can suffer from; we can find some patients with generalized or partial seizure. So, there are two
More informationTIAGABINE. THERAPEUTICS Brands Gabitril see index for additional brand names. Generic? Yes
TIAGABINE THERAPEUTICS Brands Gabitril see index for additional brand names Generic? Yes Class Anticonvulsant; selective GABA reuptake inhibitor (SGRI) Commonly Prescribed for (bold for FDA approved) Partial
More informationOXCARBAZEPINE. THERAPEUTICS Brands Trileptal see index for additional brand names. Generic? Yes
OXCARBAZEPINE THERAPEUTICS Brands Trileptal see index for additional brand names Generic? Yes Class Anticonvulsant, voltage-sensitive sodium channel antagonist Commonly Prescribed for (bold for FDA approved)
More informationSummary of Product Characteristics
1 NAME OF THE MEDICINAL PRODUCT Larig 100 mg Dispersible Tablets Summary of Product Characteristics 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each dispersible tablet contains 100mg Lamotrigine. Excipients
More information2018 American Academy of Neurology
Practice Guideline Update Efficacy and Tolerability of the New Antiepileptic Drugs I: Treatment of New-Onset Epilepsy Report by: Guideline Development, Dissemination, and Implementation Subcommittee of
More informationAED Treatment Approaches. David Spencer, MD Director, OHSU Epilepsy Center Professor, Department of Neurology
AED Treatment Approaches David Spencer, MD Director, OHSU Epilepsy Center Professor, Department of Neurology Audience Response Keypads Please utilize the keypad at your table to answer questions throughout
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Lamotrigin Medochemie 25 mg tablets Lamotrigin Medochemie 50 mg tablets Lamotrigin Medochemie 100 mg tablets Lamotrigin Medochemie 200
More informationNeuromuscular Disease(2) Epilepsy. Department of Pediatrics Soochow University Affiliated Children s Hospital
Neuromuscular Disease(2) Epilepsy Department of Pediatrics Soochow University Affiliated Children s Hospital Seizures (p130) Main contents: 1) Emphasize the clinical features of epileptic seizure and epilepsy.
More informationStatus Epilepticus in Children
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Status Epilepticus in Children. These podcasts are designed to give medical students an overview of key topics in pediatrics.
More informationChapter 24 Antiseizures
Chapter 24 1. Introduction Epilepsy is a heterogeneous symptom complex a chronic disorder characterized by recurrent seizures. Seizures are finite episodes of brain dysfunction resulting from abnormal
More informationFDA Approves Carnexiv (carbamazepine) injection as Intravenous Short-Term Replacement Therapy for Certain Seizure Types
FOR IMMEDIATE RELEASE FDA Approves Carnexiv (carbamazepine) injection as Intravenous Short-Term Replacement Therapy for Certain Seizure Types Carnexiv is the first FDA-approved intravenous carbamazepine
More informationBuspirone Carbamazepine Diazepam Disulfiram Ethosuximide Flumazeil Gabapentin Lamotrigine
CNS Depressants Buspirone Carbamazepine Diazepam Disulfiram Ethosuximide Flumazeil Gabapentin Lamotrigine Lorazepam Phenobarbital Phenytoin Topiramate Valproate Zolpidem Busprione Antianxiety 5-HT1A partial
More informationDone by: Rola Awad Presented to : Dr. Diana Malaeb Date: 28/2/2013
Done by: Rola Awad Presented to : Dr. Diana Malaeb Date: 28/2/2013 1 Abbreviations AED: antiepileptic drug EEG: electroencephalography SJS: Stevens Johnson syndrome VA: Valproic acid GABA : Gamma amino
More informationIntroduction to seizures and epilepsy
Introduction to seizures and epilepsy Selim R. Benbadis, M.D. Professor Departments of Neurology & Neurosurgery Director, Comprehensive Epilepsy Program Symptomatic seizures Head injury (trauma) Stroke
More informationEpilepsy in Pregnancy Guideline
RESTRICTED UNTIL APPROVED Epilepsy in Pregnancy Guideline Guideline Number: 633 Supersedes: Classification Clinical Version No: Date of EqIA: Approved by: Date Approved: Date made active: Review Date:
More informationTreatment Options for Seizures: Practical Points in Epilepsy Management
Lehigh Valley Health Network LVHN Scholarly Works Neurology Update for the Non-Neurologist 2013 Neurology Update for the Non-Neurologist Feb 20th, 8:10 PM - 8:40 PM Treatment Options for Seizures: Practical
More informationOn completion of this chapter you should be able to: list the most common types of childhood epilepsies and their symptoms
9 Epilepsy The incidence of epilepsy is highest in the first two decades of life. It falls after that only to rise again in late life. Epilepsy is one of the most common chronic neurological condition
More informationAPPENDIX K Pharmacological Management
1 2 3 4 APPENDIX K Pharmacological Management Table 1 AED options by seizure type Table 1 AED options by seizure type Seizure type First-line AEDs Adjunctive AEDs Generalised tonic clonic Lamotrigine Oxcarbazepine
More informationAdvances in the diagnosis and management of epilepsy in adults
n DRUG REVIEW Advances in the diagnosis and management of epilepsy in adults Diego Kaski MRCP, PhD and Charles Cockerell MD, FRCP SPL This drug review looks at the key issues in diagnosing epilepsy, initiating
More informationDavid Dredge, MD MGH Child Neurology CME Course September 9, 2017
David Dredge, MD MGH Child Neurology CME Course September 9, 2017 } 25-40,000 children experience their first nonfebrile seizure each year } AAN/CNS guidelines developed in early 2000s and subsequently
More informationDepakote ER (divalproex sodium) extended-release tablets, for oral use Initial U.S. Approval: 2000
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use Depakote ER safely and effectively. See full prescribing information for Depakote ER. Depakote ER
More informationHIGHLIGHTS OF PRESCRIBING INFORMATION
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use DIVALPROEX SODIUM DELAYED-RELEASE TABLETS safely and effectively. See full prescribing information
More informationAnti-epileptic Drugs
Anti-epileptic Drugs We will continue talking about epilepsy which is a chronic disease that has to be managed, so the treatment will be a management treatment, not a single day or week treatment we will
More informationThe Epilepsy Prescriber s Guide to Antiepileptic Drugs
The Epilepsy Prescriber s Guide to Antiepileptic Drugs The Epilepsy Prescriber s Guide to Antiepileptic Drugs Philip N. Patsalos FRCPath, PhD Professor of Clinical Pharmacology and Consultant Clinical
More informationNew AEDs in Uncontrolled seizures
New AEDs in Uncontrolled seizures Uncontrolled seizures/epilepsy Intractable epilepsy, Refractory epilepsy, Pharmacoresistant epilepsy Dr. Suthida Yenjun Traditionally, referred to therapeutic failure
More informationWomen s Issues in Epilepsy. Esther Bui, Epilepsy Fellow MD, FRCPC
Women s Issues in Epilepsy Esther Bui, Epilepsy Fellow MD, FRCPC How are women different? Different habitus Different metabolism Different co-morbidities Different psychosocial stigma Different hormonal
More informationValproate Case 1: Pharmacokinetics Jose de Leon, MD
Valproate Case 1: Pharmacokinetics 2-12-16 Jose de Leon, MD 1. Valproate Case 1 J Clin Psychopharmacology 2009;29:509-11 http://www.ncbi.nlm.nih.gov/pubmed/19745660 Educational Objectives At the conclusion
More informationThe epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care
The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care Issued: January 2012 guidance.nice.org.uk/cg137 NHS Evidence has accredited the process
More informationUpdate in Pediatric Epilepsy
Update in Pediatric Epilepsy Cherie Herren, MD Assistant Professor OUHSC, Department of Neurology September 20, 2018 Disclosures None Objectives 1. Identify common pediatric epilepsy syndromes 2. Describe
More informationThe epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care
The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care Issued: January 2012 last modified: January 2015 guidance.nice.org.uk/cg137 NICE has
More informationHow to choose/use anti-epileptic drugs wisely? Dr. Chusak Limotai, MD., M.Sc., CSCN(C)
How to choose/use anti-epileptic drugs wisely? Dr. Chusak Limotai, MD., M.Sc., CSCN(C) Talk overview When to start treatment? Which drug? Monotherapy Combining AEDs (Rational polytherapy) Old AEDs versus
More informationCase 1: Issues in this case. Generalized Seizures. Seizure Rounds with S.Khoshbin M.D. Disclosures: NONE
Disclosures: NONE Seizure Rounds with S.Khoshbin M.D. Case 1: 45 yo male while jogging with his wife stopped,acted strangely for a while then fell to the ground and had a convulsion.emt s were called by
More informationFor patients with epilepsy and the neurologists who treat them, the primary goal
38 Practical Neurology October 2008 A specialist answers the common question, My patient is seizure-free now what do I do? By Carl W. Bazil, MD, PhD For patients with epilepsy and the neurologists who
More informationNew Patient Questionnaire - Epilepsy
New Patient Questionnaire - Epilepsy Person completing this form: (if other than the patient) GENERAL SEIZURE HISTORY Relationship: When do you think your child had their first seizure? When was the last
More informationEpilepsy: a review of reports, guidelines, recommendations and models for the provision of care for patients with epilepsy
REVIEW Epilepsy: a review of reports, guidelines, recommendations and models for the provision of care for patients with epilepsy Rebecca LM Aylward ABSTRACT Epilepsy is common and has a variety of causes
More informationAlthough the prevalence of epilepsy and
NEW-ONSET EPILEPSY IN WOMEN: AN INDICATION FOR A NEWER ANTIEPILEPTIC DRUG? Jeffrey Cohen, MD, PhD* ABSTRACT Seizure patterns are often related to the reproductive cycles of a woman with epilepsy. Seizures
More informationDr. Dafalla Ahmed Babiker Jazan University
Dr. Dafalla Ahmed Babiker Jazan University change in motor activity and/or behaviour due to abnormal electrical activity in the brain. seizures in children either - provoked by somatic disorders originating
More informationAbbreviated Update: Oral Anticonvulsants New Drug: ezogabine (Potiga)
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationPerampanel (Fycompa) for paediatric epilepsy
NIHR Innovation Observatory Evidence Briefing: January 2018 Perampanel (Fycompa) for paediatric epilepsy NIHRIO (HSRIC) ID: 13251 NICE ID: 9149 LAY SUMMARY Epilepsy is a condition in which the brain is
More informationAN UPDATE ON ANTIEPILEPTIC AGENTS: FOCUS ON AN UPDATE ON ANTIEPILEPTIC AGENTS: FOCUS ON SECOND GENERATION TREATMENT OPTIONS
Volume 24, Issue 1 October 2008 AN UPDATE ON ANTIEPILEPTIC AGENTS: FOCUS ON SECOND GENERATION TREATMENT OPTIONS Jason Richey, Pharm.D. Candidate Epilepsy is a neurological disorder characterized by sudden
More informationThe Selection of Antiepileptic Drugs for the Treatment of Epilepsy in Children and Adults
The Selection of Antiepileptic Drugs for the Treatment of Epilepsy in Children and Adults Jorge J. Asconape, MD KEYWORDS Epilepsy Seizures Antiepileptic drugs Epilepsy is one of the most common chronic
More informationPaediatric Epilepsy Update N o r e e n Te a h a n canp C o l e t t e H u r l e y C N S E p i l e p s y
Paediatric Epilepsy Update 2018 N o r e e n Te a h a n canp C o l e t t e H u r l e y C N S E p i l e p s y Epilepsy Service CUH ~550 children New diagnosis-education, support, clinic follow up Epilepsy
More informationI have no financial relationships to disclose.
Julia B. Toub, MD Providence Brain & Spine Institute April 14, 2016 I have no financial relationships to disclose. 1 1. Seizure: the clinical manifestation of an abnormal and excessive synchronization
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 05 May 2010
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 05 May 2010 LAMICTAL 2 mg, dispersible / chewable tablet B/30 (CIP: 354 581-7) LAMICTAL 5 mg, dispersible / chewable
More information