-suppress electrical stimuli (Na+, Ca++)

-increase GABA (inhibits neurotransmitters)

SE: drowsiness

-doses start low, then gradually increase

-teratogenic

-deplete folic acid, need supplement

-inhibit vitamin K (clotting), need supplement if surgery

suppress Na+

ex: phenytoin (dilantin)

-anticonvulsant/hydantoin for grand mal & complex partial seizures, also for incontinence

-very teratogenic

-therapeutic range: 10-20 mcg

-po 100 mg tid

-SE/Adverse: gingival hyperplasia, slurred speech, confusion, low platelets, low WBC, hyperglycemia, hepatits

-^ effects of anticoagulants and barbiturates, decreases effects of Ca++

enhance GABA activity; for partial & grand mal seizures, status epilepticus

ex: phenoarbital

-long-acting barbiturate for seizures

-less teratogenic

-TR 15-40 mcg

-decrease Ca++, for seizures

ex: Zarontin

-succinimide for seizures

-TR 40-100 mcg

-SE/Adverse: renal & liver impairment, gastric irritation

-take with food

-benzodiazepine for seizures

-TR 20-80 mcg

-benzodiazepine drug of choice for status epilepticus

-IV

iminostilbenes for seizures, bipolar, trigeminal neuralgia, migraines

-TR 5-12 mcg

-avoid grapefruit

-valproate for bipolar

-TR 40-100 mcg

-SE/Adverse: hepatotoxic

-similar: Depakene

Monitor LFT, BUN, Cr, therapeutic range, CBC, glucose

LIVER & RENAL TOXIC

take with food, stay hydrated

women use 2 forms of birth control

avoid alcohol

don't stop abruptly

avoid herbs

ORAL HYGIENE

-ongoing seizure

-Valium drug of choice to start on

-Ativan can be used to start also

-follow with Dilantin, longer-acting

-IV push