FDA Warnings and Effects of Medications

Seizures may be:

• Only hereditary

• Always caused by trauma

• Idiopathic or secondary (tumors, metabolic disorders, drugs, withdrawal)

• Caused only by infections

Epilepsy is defined as:

• A single isolated seizure

• Seizures caused by infection

• Chronic, recurrent seizures usually requiring long-term therapy

• Seizures treated only with surgery

Types of seizures include:

• a) Petit mal and grand mal only

• b) Generalized (tonic–clonic) and partial (simple or complex)

• c) Myoclonic and febrile only

• d) None of the above

Status epilepticus is dangerous because it can cause:

• Only temporary confusion

• Hypotension, hypoxia, dysrhythmias, brain damage, death

• Sleepiness and headache

• Seizure freedom afterward

Phenobarbital carries an FDA warning for:

• Liver toxicity

• Suicidal ideation

• Agranulocytosis

• Pancreatitis

Diazepam carries an FDA warning because:

• It may cause seizures

• Benzodiazepine + opioid → CNS depression, respiratory depression, death

• It leads to liver failure

• It always causes rash

Vigabatrin carries an FDA warning for:

Valproate carries FDA warnings for all EXCEPT:

• Pancreatitis

• Teratogenicity

• Bleeding/bruising risk

• Agranulocytosis

Carbamazepine carries an FDA warning for:

• Pancreatitis

• Aplastic anemia and agranulocytosis

• Teratogenicity

• Pancreatic cancer

Carbamazepine also carries a warning for:

• Respiratory depression

• Stevens–Johnson syndrome/toxic epidermal necrolysis, especially in Asians with HLA-B*1502

• Suicidal ideation

• Visual field loss