Anticonvulsants-Dosage (Part-V)

In this article, we will discuss Anticonvulsants-Dosage (Part-V). So, let’s get started.

Anticonvulsants

Paraldehyde 0.1-0.2 ml/kg/per dose deep IM or 0.3 ml/kg/per dose per rectum mixed with 3:1 coconut oil. Additional dose may be given after 30 min and then q 4-6 hours.

Indication: Uncontrolled status epilepticus.

C/I: Pulmonary and hepatic disease.

Caution: Proctitis and abscess at injection site. Ensure sterility. Use glass syringe as paralydehyde is not compatible with plastics.

(Inj paraldehyde ampoule 5 ml, 1 g/ml).

Phenobarbitone sodium Loading dose 15-20 mg/kg IV over 15 to 20 minutes at a rate of 1 mg/kg/minute as slow bolus. May give additional 5 mg/kg doses every 15-30 minutes up to maximum total dose of 30 mg/kg. Maintenance dose 3-5 ml/kg/day q 12 hr or single dose at night p.o. or IV. Therapeutic level 15-40 mg/L.

Adult dose: 60-240 mg daily in 2-3 divided doses.

Indication: Neonatal seizures, tonic-clonic partial seizures, status epilepticus, and prophylaxis of febrile convulsions.

C/I: Porphyria, hepatic and renal disease, and severe asthma

(Gardenal, epigard, epikon tabs 30 mg, 60 mg, luminal tabs 30 mg, 100 mg; epilepsal, gardenal syrup 20 mg/5 ml; inj gardenal, phenobarbitone sodium 200 mg/ml ampoule).

Phenytoin sodium Loading dose 15-20 mg/kg slowly IV at a rate of 1 mg/kg/min. IV dose should be diluted in normal saline and not dextrose, given slowly under cardiac monitoring. Avoid IM as absorption is erratic. Maintenance dose 5-8 mg/kg/day q 8-12 hr or single dose oral. Therapeutic level 10-20 mg/L.

Adult dose: 150-300 mg daily in a single or two divided doses, increased as required to 200-400 mg/day.

Indication: Tonic-clonic seizures, partial epilepsy, cardiac arrhythmias, trigeminal neuralgia, migraine, and status epilepticus.

C/I: Porphyria, heart block.

Side Effects: Gingival hypertrophy, hirsutism, and ataxia.

(Dilantin and epileptin cap 100 mg; epsolin tab 100 mg; eptoin tabs 50 mg, 100 mg; susp dilantin 125 mg per 5 ml; syrup eptoin 30 mg per 5 ml; inj epsolin 2 ml ampoule 50 mg per ml; injection dilantin 25 mg/ml in 2 ml ampoules).

Prednisolone 2 mg/kg/day q 12 hr for 2-6 weeks. Taper it over next 4-12 weeks.

Indication: Infantile spasms, epilepsia partialis continua.

(Wysolone, nucort, omnacortil tabs 5 mg, 10 mg, 20 mg, predone, besone syrup 5 mg and 15 mg per 5 ml, kidpred 10 mg/5 ml).

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