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Pronunciation |
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(meth
SUKS i
mide) |
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U.S. Brand
Names |
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Celontin® |
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Generic
Available |
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No |
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Pharmacological Index |
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Anticonvulsant, Succinimide |
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Use |
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Control of absence (petit mal) seizures that are refractory to other drugs
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Hypersensitivity to methsuximide |
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Warnings/Precautions |
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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 |
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Adverse
Reactions |
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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 |
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Drug
Interactions |
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Methsuximide may increase the serum concentrations of phenytoin and
phenobarbital |
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Stability |
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Protect from high temperature |
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Mechanism of
Action |
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Increases the seizure threshold and suppresses paroxysmal spike-and-wave
pattern in absence seizures; depresses nerve transmission in the motor
cortex |
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Pharmacodynamics/Kinetics |
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Serum half-life: 2-4 hours
Time to peak serum concentration: Oral: Within 1-3 hours
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Usual Dosage |
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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 |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Take with food; do not discontinue abruptly; may cause drowsiness and impair
judgment |
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Nursing
Implications |
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Monitor CBC, hepatic function tests, urinalysis |
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Dosage Forms |
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Capsule: 150 mg, 300 mg |
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References |
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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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