pallav
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which drug should be used in a patient who is pregnant and is having seizures?please try and tell me and dont just write the name of thr grug and also
a logical explanation.
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| ts97
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Kaplan lectures say to use phenobarbital - no teratogenic effect. Valproic acid, phenytoin and carbamazepine - all teratogenic, spida bifida - mostly for valproic acid. Also it says "some newer drugs are also effective". I think somethink about it should be in First Aid, I didn't get the book yet.
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| pallav
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in the u.s the practice is to use phenobarbital
but it can caure respiratory depression and dependence in the child
so world over carbamazepine is preferred.
because in risk benefit ratio it wins the game
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| yasmeen
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IF PREGNANT PT IS HAVING SEIZURES FIRST THINK OF ECLAMPSIA GIVE mgso4 .IF SHE IS EPILEPTIC CARPAMEZIPINE IS PREFFERED BUT NONE OF ANTI EPILEPTICS R SAFE IN PREGNANCY INCLUDING PHENOBARBITOL AND CARBAMEZIPINE.
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| ts97
Forum Senior
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the newer drugs I wrote before are gabapentin and lamotrigine. They do not shoe teratogenity in animal studies. Is it the best choise?
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| pallav
Forum Elite
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still i'd like to agree with yasmeen
carbamezepine suits as a physician
but to crack the usmle we'll stick to phenobarbital
coz thats what kaplan says
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| MOLU
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I THINK THE PATIENT HAS TO CONTINUE WHATEVER DRUGS SHE IS ON.ALL R TERATOGENIC.SHE SHOULD B EXPLAIND PREHAND.THERE IS ALSO A RISK OF HER THRWN A CONVULSION IN PREGNANCY.
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| pallav
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molu
please AGREE to what yasmeen says
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| plastic_girl
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Yasmeen is correct, MgSO4 is the drug to use in eclampsia and if she is having convulsions for the first time, then eclampsia is definitely the first thing that should come to mind, especially if its the 2nd or 3rd trimester. Diazepam, in addition to be used for status epilepticus, can also be used in eclampsia.
If the question also tells of a history of convulsions, then she should be continued with her previous medications, but Im guessing ethosuximide doesnt cause teratogenesis, so can it be used? But yea phenobarbital is given in kaplan, so best to stick with that.
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| eva
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it's preferable to use benzodiazepine in postpartum eclampsia
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eva
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| eva
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pt who is receiving cyclophosphamide for breast cancer begins to have nasea vomiting weakness and inability to think clearly.no evidence of infection is found.her serum sodium has dropped to115 meq/l,urinary sodium level is 500 meq/l although there're no signs of oedema,which one is most likely correct?
1)hyponatremia 2)diuretics should not be given to her 3)siadh
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eva
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| pallav
Forum Elite
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dear plastic gal
i do agree that ethosuximide is not a teratogenic drug
but with all due respect id beg to differ
coz its the drug used only and only in absence seizures
so again the advice is stick to yasmeen
and eva is the answer to ur question ( 1??????????
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| Anitha
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eva answer is siadh
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