kalsam
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Mechanism of Action:
This drug increases the duration of GABA-gated channel openings. This drug is capable of producing all levels of CNS mood alteration from excitation to mild sedation, hypnosis, and deep coma. The drug depresses the sensory cortex, decreases motor activity, alters cerebellar function, and produces drowsiness, sedation, and hypnosis. The onset of action is 20 to 60 minutes for oral administration with an average duration of action of 10 to 12 hours and a half-life that averages 79 hours (with a range of 53 hours to 118 hours). This drug induces microsomal enzymes.
Indications:
* This agent is indicated for the treatment of partial and generalized tonic-clonic and cortical focal seizures.
* Treatment of acute convulsive episodes, such as status epilepticus, cholera, eclampsia, meningitis, tetanus, and toxic reactions to strychnine or local anesthetics.
Route of Administration:
Oral tablets (1/4 grain - 16.2 mg; 1/2 grain - 32.4 mg; 1 grain - 64.8 mg; and 1 1/2 grain - 97.2 mg)
Selected Adverse Effects: * CNS (somnolence, agitation, confusion, hyperkinesia, ataxia, CNS depression, nervousness, anxiety, dizziness)
* Respiratory (hypoventilation, apnea, respiratory depression)
* Cardiovascular (bradycardia, hypotension, syncope)
* GI (nausea, vomiting, constipation)
* Hypersensitivity (skin rashes, angioedema, exfoliative dermatitis)
* Hematological (megaloblastic anemia-rare)
Drug Interactions:
(Agent + drug below = Interaction) - Description of Interaction
Alcohol --- Increased CNS effects
Charcoal --- Decreased absorption
Valproic acid --- Decreased drug metabolism
Carbamazepine -- Decreased carbamazepine levels
Clonazepam --- Increased clonazepam clearance
Acetaminophen --- Increased hepatotoxicity
Anticoagulants --- Increased anticoagulant metabolism
Digoxin --- Increased digoxin metabolism
Special Considerations:
* Contraindications: porphyria, severe hepatic and respiratory disorders
* Warnings/Precautions:
o Habit forming.
o Status epilepticus may result from abrupt discontinuation.
o May increase vitamin D requirements.
o Use in the elderly (may cause excitement, depression, or confusion).
o Use in renal patients (this medication is excreted in the urine unchanged and toxicity may result).
o Pregnancy category D.
o Tartrazine sensitivity.
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| mash
Forum Fanatic
Topics: 147
Posts: 1,326
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benzodiazepine(diazepam???)
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| rida
Forum Guru
Topics: 109
Posts: 721
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Barbiturate - Phenobarbital?
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| kalsam
Forum Elite
Topics: 31
Posts: 361
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Thats correct Rida 
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| hiwa
Forum Senior
Topics: 15
Posts: 185
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Is phenobarbital used for status epilepticus ? havnt heard of it
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| dariush
Forum Elite
Topics: 20
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it sure is, in fact it is the ONLY barbituate which is used for this. B/C of a special group which i dont remember the name of. anyone knows what is the name of that molecular part which makes this special ?
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| bluestar
Forum Guru
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my question is, would USMLE give so much info to ask for a single drug?
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| kalsam
Forum Elite
Topics: 31
Posts: 361
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dariush..u r right..lemme look for the same..!!
bluestar..No..not at all..this format in USMLE,but guess it is good to know all facts in a single bunch right!!
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