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Antiepileptic drugs

Dalal, Kavitha S. PharmD; Bridgeman, Mary Barna PharmD, BCPS

doi: 10.1097/01.NURSE.0000494647.62433.d8
Department: DRUG CHALLENGE
Free

Antiepileptic medications

Kavitha S. Dalal is a critical care pharmacist at Virtua in Marlton, N.J. Mary Barna Bridgeman is a clinical associate professor at Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

Can you identify these newer medications used to treat seizure disorders? To find out, match each medication in Section I with its generic name and description in Section II.

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Section I

_____ 1. Aptiom (Sunovion Pharmaceuticals)

_____ 2. Fycompa (Eisai)

_____ 3. Onfi (Lundbeck)

_____ 4. Sabril (Lundbeck)

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Section II

a. perampanel. This medication is approved as adjunctive therapy for treatment of partial-onset seizures with or without secondarily generalized seizures, and as adjunctive therapy for treatment of primary generalized tonic-clonic seizures, in patients with epilepsy age 12 or older. Administer doses at bedtime without regard to food. A boxed warning highlights dose-related serious neuropsychiatric events including (but not limited to) aggression, anger, homicidal ideation, and hostility. These have been reported to occur during the first 6 weeks of therapy in patients with or without a psychiatric history.

b. eslicarbazepine. Indicated as monotherapy or adjunctive therapy to treat partial-onset seizures, this drug can be administered without regard to food and the tablets may be swallowed whole or crushed. Dosage adjustment is indicated for patients with moderate-to-severe renal impairment; it's not recommended for patients with severe hepatic impairment.

c. clobazam. This benzodiazepine is indicated for adjunctive therapy of seizures associated with Lennox-Gastaut syndrome in patients age 2 and older. Dosages should be adjusted for patients who are poor CYP2C19 metabolizers because concentrations of the active metabolite have been shown to be three to five times higher in these patients than in extensive metabolizers. The drug is available as a tablet or an oral suspension.

d. vigabatrin. Given twice daily, this oral antiepileptic drug is indicated as monotherapy for infantile spasms and as adjunctive therapy for refractory complex partial seizures for patients age 10 and older. It has a boxed warning for permanent vision loss and is available only through a restricted program.

ANSWERS: 1b, 2a, 3c, 4d

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