Pediatric patients antiepileptics

One of the oldest antiepileptic drugs, bromide, has been repotted to boost inhibition by an unknown mechanism. Bromide is still in use in certain cases of tonic-clonic seizures and in pediatric patients with recurrent febrile convulsions and others. The mechanism of action may include a potentiation of GABAergic synaptic transmission, although the precise target is not known. 

A pediatric patient treated for grand mal seizures develops abnormal values on liver function tests. Which of the following antiepileptic agents would cause this to occur ... 

Very few examples of outcomes research in neurological pharmacy exist. However, one historical control study determined that the implementation of a pharmacokinetics consultation service in an epilepsy clinic decreased seizure frequency and number of adverse effects compared with the baseline frequency in the 4 months prior to offering the service.A second study conducted in the pediatric epilepsy population described the effect of establishment of a specialty pediatric epilepsy clinic with clinical pharmacy services. Compared with patients seen before the beginning of the clinic, patients seen in the specialty clinic had decreased numbers of antiepileptic drugs and decreased doses of these medications. Frequency of seizures was not examined in this report. 

The H-NMR pattern in vitro, 600 MHz) of cerebrospinal fluid (CSF) of a patient with creatine deficiency syndrome (a) compared with normal CSF (b). Note the near absence of creatine and creatinine in the patient s CSF. The ethosuximide observed in the patient s CSF is a drug used in antiepileptic therapy. [Reproduced with permission from A. Schulze et al., Creatine deficiency syndrome caused by guanidinoacetate methyltransferase deficiency diagnostic tools for a new inborn error of metabolism. J. Pediatr. 131, 626 (1997).]... 

Percentages do not add up to 100% because some patients had multiple etiologies. (AED = antiepileptic drug CVA = cerebrovascular accident) More than half of remote causes were congenital malformations and CVA in pediatric and adult patients, respectively. 

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