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Archive for the 'Epilepsy' Category

DRUGS FOR PARTIAL SEIZURES AND TONIC-CLONIC SEIZURES: REACTIONS TO PHENOBARBITAL AND OTHER BARBITURATE DRUGS

Author: admin
02 17th, 2011
A skin rash may be the first sign of an allergic reaction to phenobarbital (or to any other drug). A child who develops a skin rash during the first two to three weeks of treatment with any anticonvulsant should immediately be seen by his physician. While most such rashes are NOT caused by the drug, continuing the drug in a child who is allergic to it may lead to severe and even fatal consequences.
Side effects that are dose-related are seen in certain children. The most important side effects of phenobarbital in children are its impacts on learning and behavior. While these side effects can occur in any child if the blood level is sufficiently high, certain individuals may react adversely even at “normal” blood levels.
Phenobarbital can also cause sedation (sleepiness). Many children become tolerant of this tired feeling. In others, the tired feeling continues and they do not tolerate the drug. Giving phenobarbital at bedtime may help to minimize this problem. Disturbances of sleep also can occur from use of the drug.
Hyperactivity, a behavioral side effect, may occur in 2.0 to 40 percent of young children taking phenobarbital. Hyperactivity is more common in children who were quite active to begin with. In one study, more than half of the children had to be taken off this drug because of the side effects of irritability and behavior problems.
Effects of phenobarbital on a child’s learning ability may be its most disturbing side effect. These symptoms may be subtle and difficult to recognize and may account for some of the learning problems previously attributed to epilepsy itself. Most, perhaps all of these side effects are thought to disappear when phenobarbital is discontinued. Recent studies have also found an increased incidence of depression in adolescents who take phenobarbital, perhaps more frequent when there is a family history of depression. In some children, a depression thought to be caused by an emotional reaction to having epilepsy disappears when another medication is substituted for phenobarbital.
We prefer, for all these reasons, not to use phenobarbital when alternative drugs are available, especially because of our concern about its effects on learning and behavior in the vulnerable young child. When we do use it, we carefully monitor the child’s behavior and school performance.
*118\208\8*

DRUGS FOR PARTIAL SEIZURES AND TONIC-CLONIC SEIZURES: REACTIONS TO PHENOBARBITAL AND OTHER BARBITURATE DRUGSA skin rash may be the first sign of an allergic reaction to phenobarbital (or to any other drug). A child who develops a skin rash during the first two to three weeks of treatment with any anticonvulsant should immediately be seen by his physician. While most such rashes are NOT caused by the drug, continuing the drug in a child who is allergic to it may lead to severe and even fatal consequences.Side effects that are dose-related are seen in certain children. The most important side effects of phenobarbital in children are its impacts on learning and behavior. While these side effects can occur in any child if the blood level is sufficiently high, certain individuals may react adversely even at “normal” blood levels.Phenobarbital can also cause sedation (sleepiness). Many children become tolerant of this tired feeling. In others, the tired feeling continues and they do not tolerate the drug. Giving phenobarbital at bedtime may help to minimize this problem. Disturbances of sleep also can occur from use of the drug.Hyperactivity, a behavioral side effect, may occur in 2.0 to 40 percent of young children taking phenobarbital. Hyperactivity is more common in children who were quite active to begin with. In one study, more than half of the children had to be taken off this drug because of the side effects of irritability and behavior problems.Effects of phenobarbital on a child’s learning ability may be its most disturbing side effect. These symptoms may be subtle and difficult to recognize and may account for some of the learning problems previously attributed to epilepsy itself. Most, perhaps all of these side effects are thought to disappear when phenobarbital is discontinued. Recent studies have also found an increased incidence of depression in adolescents who take phenobarbital, perhaps more frequent when there is a family history of depression. In some children, a depression thought to be caused by an emotional reaction to having epilepsy disappears when another medication is substituted for phenobarbital.We prefer, for all these reasons, not to use phenobarbital when alternative drugs are available, especially because of our concern about its effects on learning and behavior in the vulnerable young child. When we do use it, we carefully monitor the child’s behavior and school performance.*118\208\8*



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