Childhood Epilepsy

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Common Anticonvulsant Drugs : -
Drug Seizure type Oral Dose Loading Therapeutic Dose(IV) Level (ug/mL) Side effects Serum and Toxicity
Carba mazepine (CBZ) Generalised tonic-clonic Partial Begin 10 mg/ kg/24 hr increase to 20 mg/kg/24hr -- 8-12 Dizziness, drowsiness diplopia,liver dysfunction, anemia, leukopenia
Clonazepam Absence Myoclonic Infantile Spasms Partial Begin 0.05 mg/ kg/24 hr Increase 0.05 mg/kg/wk Maximum 0.2 mg/kg/24 hr -- >0.013 Drowsiness, Irritability behavioral abnormalities depression, excessive salivation
Ethosuximide Absence Myoclonic Begin 20 mg/ kg/24 hr Increase to maximum of 40 mg/kg/24hr 0r 1.5 g/24 hr whichever is less -- 40-100 Abdominal discomfort skin rash, liver dysfunction, Leukopenia
Nitrazepam Absence Myoclonic infantile spasms Begin 0.2 mg/kg/24 hr Increase slowly to 1mg/kg/24hr -- Similar to clonazepam
Paraldehyde Generalised status epilepticus Make a 5% solution by adding 1.75 mL of paral dehyde to D5W with total volume of 35 mL 150-200 mg/kg. Mainte- nance 20 mg kg/hr 10-40
Phenobarbital(PB) Generalised tonic clonic Partial 3-5 mg/kg/hr 10-20 mg/kg 20-30 mg/kg in the neonate 15-40 Hyperactivity, irritability short attention span temper tantrums, altered sleep pattern, Stevens-Johnson syndrome, depression of cognitive function
Phenytoin(PTH) Generalised tonic clonic Partial 5 mg/kg/24hr 10-20 mg/kg 10-20 Hirsutism, gum hypertrophy, ataxia, skin rash, Stevens- Johnson syndrome
Primidone Generalised tonic clonic Partial Begin 50 mg/24 hr in two divided doses Gradually increase to 150-500 mg/ 24 hr given in three divided doses -- 5-12 Aggressive behavior personality changes similar to phenobar bital
Sodium Valproate(VA) Generalised tonic clonic Absence Myoclonic Partial Begin 10 mg/kg/ 24 hr Increase by 5-10 mg/kg/wk Usual dose 30-40 mg/kg/24 hr -- 50-100 Weight gain, alopecia hepatotoxicity

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