Diapositiva 1

CASE PRESENTATION1A 15 years old Male Patient was admitted in male medical wardC/O:1.Vomiting 2.One Episode of Convulsion 3.Head ache4.Feeling sickness12-6-201113-6-20111.One Episode of Convulsion2.Vomiting2O/E:Temperature : 98.6F BP : 110/90mmhg P/A : SoftH/o Vomiting12-6-201113-6-2011H/O of Epilepsy one episodeVomiting one time. 3PAST MEDICAL & MEDICATION HISTORYNILLSMOKING :DRINKING :OCCUPATION : NON-SMOKERNON-ALCHOHALIC STUDENTHISTORYNot know DM, TB, HTNCVS Problems 4IMPRESSIONEEG :High Voltage Poly Spikes seen10-30HZ/Sec

5DIAGNOSIS :EPILEPSY (GTCS)6Definition :SEIZUREEPILEPSY7ETIOLOGY:1.GENETIC :Hereditary factors & Mutation of Gene

2.BRAIN LESION :Mainly due to Birth Trauma

3.INFECTIONS :Cerebral Meningitis & Brain Abscess

4.METABOLIC DISORDER :Hypoxia, Hypoglycemia, Hyperpyrexia

5.WITHDRAWAL OF ANY DRUG ABUSE:8Classification:GENERALISED PARTIAL SEIZUREUNCLASSIFIEDPETIT MALMYOCLONICATONICCLONICGRAND MAL SIMPLE PARTIALCOMPLEX PARTIALFEBRILE SEIZURESINFANTILE SPASM9ENDOGENOUS ANTI-SEIZURE SUBSTANCE:Regulatory MechanismPURINE NUCLEOSIDE - ADENOSINEINHIBIT SEIZURE ACTIVITY10Present Medication HistoryBRANDNAMEGENERIC NAMEDOSEFQROA1.Inj.Eptoin PHENYTOIN100mg50mg/ml TIDI.V2.Inj.ZoferONDANSTERON2 A(2mg/ml) TIDI.V3.Inj.PantopPANTA PRAZLOE40mg STATI.V4.Tab.TegretolCARBAMAZEPINE200 mg B.DOral5.Inj.RantacRANITIDINE50mg/2ml

BDI.V11Problem 1Findings :Phenytoin + CBZ Assessment :Alteration in serum Phenytoin level (or) Carbamazepine level Need to change the time interval between these two drugs Resolution :12Problem 2Findings :Assessment :Resolution :ONDANSETRON + FOODNeed to administer drug with empty stomach. High fatty food may to decrease the rate of absorption of drug.13Problem 3Findings :Assessment :Resolution :CBZ + Grape Juice/Fruit JuiceNeed to avoid the Citrus fruitsduring Therapy ..May decreases the level of CBZ and may cause the convulsion 14Patient Counseling :Phenytoin :To use same Brand of Phenytoin,Advice patient to take Phenytoin along with any Food or Drink, to minimize GIT distressCarbamazepine :Store drug in cold place & dry placeWarn Patient not to stop Drug by sudden..15Patient Counseling :Patient is advised to use medicated templates and bracelets.

If patient is epilepsy free for 2 years then he can with drawl the drug.

If necessary need to use Monotherapy.. 16THANKING YOU 17