In this article, we will discuss Anticonvulsants-Dosage (Part-VI). So, let’s get started.
Anticonvulsants-Dosage
Primidone Newborn: 12-20 mg/kg/day q 6-12 hr, children <8 yr: 10–25 mg/kg/day q 8-12 hr, children >8 yr: 125-1500 mg/day p.o. adjusted to patient’s tolerance and response (maximum dose 2 g/24 hr). Therapy should be initiated at 1/3 to 1/2 of initial dose.
Adult dose: Start with 50 mg/d and gradually increase every 2-3 weeks up to maximum daily dose of 750 mg.
Indication: Partial and tonic-clonic seizures. (Mysoline tab 250 mg).
Pyridoxine For pyridoxine dependent seizures: Give 50-100 mg/dose IM or rapid IV, under EEG control. Maintenance dose 50-100 mg/day oral (For formulations, see Vitamins section).
Thiopental 5-10 mg/kg loading dose IV over 2-5 minutes followed by 2-10 mg/kg/hr continuous infusion for uncontrolled status epilepticus, patient will need mechanical ventilation.
Adult dose: 100-150 mg over 10-15 seconds; repeat if required after 20-30 seconds.
(Inj pentothal 250 mg, 500 mg, 1 g vials; inj anesthal, intraval sodium, thiosol 500 mg, 1 g ampoules or vials).
Topiramate Initial dose 0.5-1.0 mg/kg/day, gradually increased every 2 weeks up to 5-10 mg/kg/day q12 hr or single daily dose. For migraine prophylaxis, give one-half the dosec(2 mg/kg single dose per day).
Adult dose: 25 mg daily for 1 week, increase by 25-50 mg daily at 1-2 weeks intervals. Usual dose is 200-400 mg in 2 divided doses; maximum 800 mg/day.
Indication: Add-on therapy for refractory partial seizures, primary generalized tonic-clonic seizures, absence seizures, Lennox-Gastaut syndrome, and West syndrome.
Side Effects: Anorexia, weight loss, dizziness, blurring of vision, glaucoma, metabolic acidosis, ataxia, and renal calculi.
(Topamax 25 mg; topex tabs 25 mg, 100 mg, topirol tabs 25 mg, 50 mg, 100 mg).