Medications for Epilepsy

Medications for Epilepsy - Common Drugs (I will expand and speak about medications) and may need to be split into 2 videos

Diazepam/Lorazepam

Carbamazepine

Sodium Valproate

Clonazepam

Lamotrigine

Gabapentin

Phenobarbital

Phenytoin

Use for Epilepsy and Other Conditions

•      Status Epilepticus        

•      Serial Seizures

•      Febrile Convulsions

•      Reduces Anxiety

•      Sedation for medication procedures

•      Muscle Relaxant

•      Hypnotic drug (for sleep disorders)

•      Pre-operative sedation.

Medications for Epilepsy

Common Drugs

Brand Names

Diazepam/Lorazepam

Dialar, Diazemuls, Diazepam Rectubes, Rimapam, Stesolid, Tensium, Valclair (L), Ativan

Carbamazepine

Carbagen SR, Epimaz, Tegretol, Tegretol Retard

Sodium Valporate

Convulex (valporic acid), Epilim, Epilim Chrono, Depakote, Orlept

Clonazepam

Rivotril

Gabapentin

(partial seizures)

Neurontin

Lamotrigine

Lamatical

Phenobarbital

None

Phenytoin/Fosphenytoin

(P) Epanutin

(F) Pro-Epanutin 

Common Drugs - Side Effects

Common – Most need monitoring, in severe circumstances discuss with Doctor and in some instances stop taking

Rare – In all cases discuss with Doctor, some circumstances stop taking and in extreme call Doctor immediately

Organisation policy and procedure will need to followed for dealing with medication side effects monitoring and actions to take.

What is Buccal Midazolam?

•      Midazolam is an effective short acting benzodiazepine used and administered into the Buccal Cavity

•      It is used in the treatment of prolonged seizures and to prevent progression to status epilepticus

•      It's an alternative to rectal administration of Diazepam

•      It is unlicensed use for aborting seizures but is supported by NICE (2004).

•      Does not require special storage - Do not refrigerate or freeze

•      Buccolam has a shelf life of 18 months (Make sure to Check Expiry Date)

•      Buccolam is to be administered into the buccal cavity

•      Buccolam is prescribed off-license for over 18’s.

Administration

Why use it?

•      To prevent further harm to the person

•      Route of administration can be via the buccal or nasal cavity

•      Dose: No more than 20mg in 24 hours period.

Side Effects

Common side effects

•      Sedation

•      Drowsiness

•      Light-headedness

•      Decreased alertness

•      Unsteadiness.

Less common side effects

•      Low blood pressure

•      Slow heart rate

•      Skin reactions

•      Visual disturbances

•      Headache

•      Confusion

•      Breathing difficulties

•      Central Nervous System (CNS) toxicity risk if the patient takes antidepressants, antipsychotics or lithium.

•      You will need to monitor the person closely after administering either of these drugs, as they are drugs that often cause sedation, drowsiness, dizziness and headache

•      There is a possibility the drug may cause respiratory depression, though this is less likely with Midazolam than with Diazepam

Your work place should have a drug book (often a British National Formulary BNF) where all side effects will be listed: you will need to be aware of these.

General Information

•      Most people requiring rescue med are prescribed midazolam (Epistatus)

•      GPs and specialists are willing to prescribe

•      Carers and relatives need instruction in its use

•      For paid care staff recognised training and a signed protocol are essential.