Pharmacological Management
(1)Phenobarbital:
First choice for partial and generalized tonic-clonic seizures.Should not be used to treat the seizures associated with cerebral malaria
Loading dose:200mg im,stat,then start at 1mg/kg po od,building up to 3mg/kg(max 180mg)od nocte
SE's:Long Half life,respiratory depression
(2)phenytoin:
Reserve drug for tonic-clonic and partial seizures(not for absences).Start at 2.5mg/kg po od,building up to 5.0(max8.0)mg/kg po od.
SE's:very toxic drug,plasma levels should ideally be monitored.
(3)Female patient in childbearing age:
Add Folic acid,5 mg/d;Pre-conception counselling about AE's in pregnancy and while breastfeeding.
(4)Further management:
Admit until tests are done/patient 24 hours free of fits councel the patient and guardian about special risks:No swimming/hights/driving(at least 1 year after fit).
Abbreviations(https://www.daowen.com)
DDX(difficulty diagnosis):不同的诊断
LFT's(liver function test):肝功检查
SE's:副作用
PO:口服。
qd:一日1次
Dx(diagnosis):诊断
ONSET(beginning):开始
LP(lumbar puncture):腰穿
EEG:脑电图
MAX:最大剂量
译文