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Methsuximide
Pronunciation
U.S. Brand Names
Generic Available
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(meth SUKS i mide)

U.S. Brand Names
Celontin®

Generic Available

No


Pharmacological Index

Anticonvulsant, Succinimide


Use

Control of absence (petit mal) seizures that are refractory to other drugs


Pregnancy Risk Factor

C


Contraindications

Hypersensitivity to methsuximide


Warnings/Precautions

Use with caution in patients with hepatic or renal disease; abrupt withdrawal of the drug may precipitate absence status; methsuximide may increase tonic-clonic seizures in patients with mixed seizure disorders; methsuximide must be used in combination with other anticonvulsants in patients with both absence and tonic-clonic seizures


Adverse Reactions

Cardiovascular: Hyperemia

Central nervous system: Ataxia, dizziness, drowsiness, headache, aggressiveness, mental depression, irritability, nervousness, insomnia, confusion, psychosis, suicidal behavior, auditory hallucinations

Dermatologic: Stevens-Johnson syndrome, rash, urticaria

Gastrointestinal: Anorexia, nausea, vomiting, weight loss, diarrhea, epigastric and abdominal pain, constipation

Genitourinary: Proteinuria

Hematologic: Leukopenia, pancytopenia, eosinophilia, monocytosis

Ocular: Blurred vision, photophobia, peripheral edema


Drug Interactions

Methsuximide may increase the serum concentrations of phenytoin and phenobarbital


Stability

Protect from high temperature


Mechanism of Action

Increases the seizure threshold and suppresses paroxysmal spike-and-wave pattern in absence seizures; depresses nerve transmission in the motor cortex


Pharmacodynamics/Kinetics

Serum half-life: 2-4 hours

Time to peak serum concentration: Oral: Within 1-3 hours


Usual Dosage

Oral:

Adults: 300 mg/day for the first week; may increase by 300 mg/day at weekly intervals up to 1.2 g/day in 2-4 divided doses/day


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Take with food; do not discontinue abruptly; may cause drowsiness and impair judgment


Nursing Implications

Monitor CBC, hepatic function tests, urinalysis


Dosage Forms

Capsule: 150 mg, 300 mg


References

Baehler RW, Work J, Smith W, et al, "Charcoal Hemoperfusion in the Therapy for Methsuximide and Phenytoin Overdose," Arch Intern Med, 1980, 140(11):1466-8.

Karch SB, "Methsuximide Overdose: Delayed Onset of Profound Coma," JAMA, 1973, 223(13):1463-5.

Miles MV, Tennison MB, and Greenwood RS, "Pharmacokinetics of N-desmethylmethsuximide in Pediatric Patients," J Pediatr, 1989, 114(4 Pt 1):647-50.

Tennison MB, Greenwood RS, Miles MV, "Methsuximide for Intractable Childhood Seizures," Pediatrics, 1991, 87(2):186-9.


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