McKenna's Pharmacology for Nursing, 2e

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P A R T 4  Drugs acting on the central and peripheral nervous systems

TABLE 23.3

DRUGS IN FOCUS Drugs for treating partial seizures

Drug name

Dosage/route

Usual indications

Adult: 800–1200 mg/day PO in divided doses q 6–8 hours Paediatric (>12 years): adult doses, do not exceed 1000 mg/day Paediatric (6–12 years): 20–30 mg/kg per day PO in divided doses t.d.s. to q.i.d. Paediatric (<6 years): 35 mg/kg per day PO Adult: 900–1800 mg/day PO in divided doses t.d.s. Paediatric (3–12 years): 10–15 mg/kg per day PO in divided doses Adults : 50–200 mg PO or IV b.d. Paediatric (>16 years): 50–200 mg PO or IV b.d. Adult: 300–500 mg/day PO in divided doses b.d. Paediatric (2–12 years): 1–5 mg/kg per day PO in divided doses b.d. Paediatric (>12 years): 100–400 mg/day PO in divided doses b.d. Adult: 500 mg PO b.d. up to 3000 mg/day Paediatric (4–16 years): 10 mg/kg PO b.d. to a maximum of 1500–3000 mg/day

Drug of choice for treatment of partial seizures and tonic–clonic seizures; treatment of trigeminal neuralgia, bipolar disorder

carbamazepine (Tegretol)

gabapentin (Neurontin)

Used as adjunct in treating partial seizures; treatment of postherpetic pain in adults and children ages 3–12 years of age; has orphan drug status for the treatment of amyotrophic lateral sclerosis; treatment of pain, migraines, bipolar disorders, tremors of multiple sclerosis and nerve- generated pain states Used as adjunct in treating partial seizures with or without secondary generalisation Used as adjunct or for monotherapy in treating partial seizures and in treatment of seizures associated with Lennox– Gastaut syndrome in adults and children ≥2 years of age; long-term treatment of bipolar disorders Newer drug approved for adjunctive treatment of partial seizures in adults and children ≥4 years of age; in 2007, it was also approved for the treatment of primary generalised tonic–clonic seizures in adults and treatment of children ≥6 years of age with idiopathic generalised epilepsy; being studied for use in absence seizures, myoclonic seizures and drug-resistant seizures of multiple types Used for monotherapy or adjunctive therapy in treatment of partial seizures in adults and children 4–16 years of age; also being studied as an alternative treatment of bipolar disease Used for adjunctive treatment of adults with partial-onset seizures; management of neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia; fibromyalgia Used as adjunct in treating partial seizures in and in children 12–18 years of age Used as adjunct in treating partial seizures in adults and children 2–16 years of age; also approved for treatment of tonic– clonic seizures, for prevention of migraine headaches, and as adjunct therapy in Lennox–Gastaut syndrome; being studied for use in cluster headaches, infantile spasms, alcohol dependence, bulimia nervosa and weight loss

lacosamide (Vimpat)

lamotrigine (Lamictal)

levetiracetam (Keppra)

oxcarbazepine (Trileptal)

Adult: 600 mg PO b.d. Paediatric (4–16 years): 8–10 mg/kg per day PO

pregabalin (Lyrica)

150–600 mg/day PO in divided doses Neuropathic pain: 100 mg PO t.d.s. Postherpetic neuralgia: 75–150 mg PO t.d.s.

tiagabine (Gabitril)

Adults and paediatrics (>12 years): Initially 7.5–15 mg/day PO in three divided doses, up to 30–50 mg/day PO Adults 500–1000 mg PO daily in two divided doses Paediatric (2–16 years): 3–6 mg/kg per day PO in two divided doses

topiramate (Topamax)