Neurology Exam Prep Podcast Episode 16 - An Overview of Antiseizure Drugs
Jul 23, 2020
Explore the intriguing world of antiseizure medications, starting with a case-based approach that highlights the complexities of treating epilepsy. Discover how patient history and drug interactions shape medication choices, especially during pregnancy. Learn about ethosuximide as the go-to for absence epilepsy, and delve into Dravet syndrome’s unique challenges. Get insights on the rapid efficacy of intranasal midazolam for seizure clusters, and understand the risks of skin rashes in elderly patients. Finally, examine effective administration strategies for urgent seizure management.
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Selecting Anti-Seizure Drugs
- Consider six key factors when choosing anti-seizure drugs: epilepsy syndrome, side effects, pharmacokinetics, pharmacodynamics, pregnancy implications, and cost.
- Tailor medication choice to patient specifics including syndrome and comorbidities for optimal outcomes.
Choosing Drugs for Juvenile Myoclonic Epilepsy
- Lamotrigine is often preferred for young women with juvenile myoclonic epilepsy due to pregnancy safety and mood stabilization.
- However, levetiracetam, despite broad spectrum efficacy, may worsen depression and requires caution with psychiatric history.
Proactive Pregnancy Counseling
- Discuss pregnancy potential proactively with all women of childbearing age on anti-seizure drugs.
- Prescribe folic acid supplementation early to reduce neural tube defects and support fetal neurodevelopment.