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الموضوع: استفسار عن EPANUTIN 100 MG + Keppra 500 mg

  1. #1

    Exclamation استفسار عن EPANUTIN 100 MG + Keppra 500 mg

    وصف طبيب المخ و الأعصاب لوالدي دوائان :

    1/ EPANUTIN 100 MG ==>> ثلاث كبسولات في اليوم ( كبسولتين صباحا - كبسوله مساء)

    2/ Keppra 500 mg ==>> حبه واحده في اليوم (نصف حبه صباحا - نصف حبه مساء)

    ومنذ الاستخدام و هو في حالة لا يعلم بها الا الله فهو كأنه في غيبوبه ..



    و هنالك طبيبان آخران في مستشفى ثانيه قالوا يجب التوقف عن EPANUTIN 100 MG

    لأنه هو الذي متعب والدي و لكن نوقفه بالتدريج ..

    ولكن طبيب المخ و الأعصاب رفض هذه الفكره وقال : ممنوع التوقف عن أي دواء منهما ..

    ما العمل ؟


    وهل ذلك صحيح بأن هذان الدوائان لا تستخدم مع بعضهما البعض ؟؟؟ وهل لهم أضرار ؟؟؟


    افيدوني جزاكم الله خيرا ..

  2. #2

    افتراضي

    ياخوي بالنسبه لادواء الاول يHow does it work?

    Epanutin capsules, oral suspension and infatabs all contain the active ingredient phenytoin, which is a type of medicine called an anticonvulsant. (NB. Phenytoin is also available without a brand name, ie as the generic medicine.) Phenytoin is used to treat epilepsy and works by stabilising electrical activity in the brain.

    The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This can result in fits or seizures.

    Phenytoin prevents seizures by preventing the excessive electrical activity in the brain. It is thought to achieve this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As phenytoin prevents this, it helps stabilise the electrical activity in the brain.

    As phenytoin stabilises electrical nerve activity, it can also be used to treat a condition called trigeminal neuralgia, in which the facial nerves spontaneously send messages of pain to the brain. Phenytoin prevents the nerve signals being sent inappropriately and relieves the pain of this condition. Phenytoin should only be used as second line therapy for this condition, in people who cannot take another medicine called carbamazepine, or for people in whom carbamazepine is ineffective.

    What is it used for?


    Epilepsy. Phenytoin is used to treat generalised tonic-clonic seizures (grand mal epilepsy) and partial seizures.


    Seizures associated with brain surgery or head injury.


    Severe pain in the lips, gums, cheek, chin or eye caused by a disorder of the nerves in the face (trigeminal neuralgia).


    Warning!


    You should not suddenly stop taking this medicine unless your doctor tells you otherwise, as suddenly stopping treatment is likely to make your seizures return.


    Different people can vary widely in the way their bodies respond to and metabolise phenytoin. This can also be affected by many other medicines (see end of factsheet for more details). As a result, your phenytoin dose will need to be individualised. When you start treatment, your dose will be gradually increased and your doctor may need to take blood tests from time to time to check the amount of phenytoin in your blood. You should try not to miss any doses of your medicine, as this can cause a marked change in the level of phenytoin in your blood.


    If the level of phenytoin in your blood gets too high, it can cause symptoms such as confusion, rapid involuntary eye movements, blurred vision, slurred speech or clumsy movements. You should tell your doctor if you experience any of these symptoms while taking phenytoin, so that your blood level of phenytoin can be measured and your dose reduced if necessary.


    If you get a skin rash or other signs of allergic reaction while taking this medicine, such as a fever or swollen glands, you should inform your doctor immediately.


    This medicine may rarely cause problems with your blood cells. For this reason you should have regular blood tests to monitor the levels of your blood cells. You should consult your doctor immediately if you experience any of the following symptoms, as these may signs of problems with your blood cells: unexplained bruising or bleeding, purple spots, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness.


    Phenytoin can lower the amount of folic acid in your blood, which could cause folate-deficiency anaemia. It is recommended that you have a blood test every six months to check the amount of folate in your blood. Your doctor may prescribe folic acid supplements if your levels are too low.


    Phenytoin can interfere with the way the body metabolises vitamin D. If you don't get enough vitamin D from your diet or from exposure to sunlight, this could cause bone pain, fractures, or a disease called ricketts. Ask your doctor or pharmacist for more information.


    Phenytoin decreases the blood levels of hormonal contraceptives that contain oestrogen and/or progesterone. This can make these types of contraceptive ineffective, or cause breakthrough bleeding. Women taking phenytoin who need contraception should be prescribed hormonal contraceptives that contain a total of at least 50 micrograms of ethinylestradiol (oestrogen), or use non-hormonal methods of contraception, such as condoms. It is important for women who could get pregnant to discuss contraception and pregnancy with their doctor before starting treatment with this medicine.


    Epanutin infatabs should be sucked or chewed. The tablets contain sucrose and may be harmful to the teeth when used long-term.


    Use with caution in


    Elderly people.


    Decreased liver function.


    High levels of urea in the blood (uraemia).


    Diabetes.


    Hereditary blood disorders called porphyrias.


    People who drink large amounts of alcohol.


    Not to be used in


    Allergy to phenytoin or other medicines of this type (hydantoins).


    Epanutin infatabs contain sucrose and are not suitable for people with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency.


    Epanutin capsules contain lactose and are not suitable for people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose metabolism.


    This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.


    It is vital that women with epilepsy receive specialist advice before getting pregnant, so they are well informed of potential risks and benefits of continuing antiepileptic treatment. Pregnant women taking antiepileptic medicine have a higher risk of carrying a baby with developmental problems and malformations. However, if a woman with epilepsy stops treatment because she is pregnant, there is a risk of seizures that can harm both mother and baby. This risk may be higher than that from continuing the medication. It is important that all the risks and benefits of treatment are weighed up. Seek medical advice from your doctor.


    Women who decide to try for a baby while taking phenytoin should start taking folic acid daily as soon as contraception is stopped, as this may reduce the risk of neural tube defects such as spina bifida in the baby. Ask your doctor for advice on the dose to take - it may be recommended that you take 5mg daily.


    This medicine passes into breast milk. The manufacturer recommends that women taking this medicine should avoid breastfeeding their infants and bottlefeed instead. Seek medical advice from your doctor.


    Label warnings


    Do not stop taking this medication except on your doctor's advice.


    Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.


    Rapid involuntary movements of the eyes (nystagmus).


    Shaky movements and unsteady walk (ataxia).


    Slurred speech.


    Decreased co-ordination.


    Confusion.


    Drowsiness.


    Dizziness.


    Pins and needles sensations.


    Nervousness.


    Difficulty sleeping (insomnia).


    Twitching.


    Headache.


    Nausea and vomiting.


    Constipation.


    Skin rashes.


    Disturbances in the normal numbers of blood cells in the blood.


    Liver problems.


    Increased hair growth (hirsutism).


    Enlargement of the gums or lips.


    Coarsening of facial features.


    The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

    For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    Phenytoin can interact with many medicines and the dose of phenytoin or the interacting medicine may need to be altered as a result. It is important to tell your doctor what medicines you are taking, including herbal medicines and non-prescription medicines, before you start phenytoin. Likewise, once you are taking phenytoin it is important to check with your doctor or pharmacist before you stop taking any existing medicines, or start taking any new medicines, including herbal medicines and those bought without a prescription.

    The following medicines may reduce the breakdown of phenytoin in the body. As this could increase the level of phenytoin in your blood and may increase the risk of side effects, your doctor may need to decrease your phenytoin dose if you are prescribed any of these:


    amiodarone


    azapropazone


    benzodiazepines, eg diazepam or chlordiazepoxide


    capecitabine


    chloramphenicol


    cimetidine


    clarithromycin


    diltiazem


    disulfiram


    felbamate


    fluconazole


    fluoxetine


    fluvoxamine


    isoniazid


    leflunomide


    methylphenidate


    metronidazole


    miconazole


    modafinil


    nifedipine


    omeprazole


    phenothiazines, eg chlorpromazine, prochlorperazine, thioridazine (these may also decrease the blood level of phenytoin)


    phenylbutazone


    sulfinpyrazone


    sulphonamides, eg co-trimoxazole, sulfamethoxazole, sulfadiazine


    topiramate


    trimethoprim


    viloxazine


    voriconazole.


    The following medicines may increase the breakdown of phenytoin in the body. As this could decrease the level of phenytoin in your blood and may make it less effective, your doctor may need to increase your phenytoin dose if you are prescribed any of these:


    diazoxide


    folic acid


    rifampicin


    sucralfate


    the herbal remedy St John's wort (Hypericum perforatum) - this should not be taken by people who are taking phenytoin


    vigabatrin.


    The effects of phenytoin on other anticonvulsant medicines, and of other anticonvulsants on phenytoin, are fairly unpredictable. If more than one anticonvulsant is being used at the same time, the blood levels of the medicines, their effect on seizures, and the emergence of side effects should be well monitored.

    Chemotherapy medicines used to treat cancer can affect the blood level of phenytoin. Your phenytoin blood level should be monitored if you have chemotherapy.

    Phenytoin may may increase the breakdown of the following medicines in the body. As this could decrease the level of these medicines in the blood and may make them less effective, your doctor may need to prescribe a larger than normal dose of these:


    abacavir


    antifungal medicines, eg fluconazole, ketoconazole, itraconazole, voriconazole


    aprepitant


    aripiprazole


    bupropion


    busulfan


    calcium channel blockers, eg felodipine, nimodipine, verapamil


    ciclosporin


    clozapine


    corticosteroids, eg dexamethasone, fludrocortisone, methylprednisolone, prednisolone


    digoxin


    digitoxin


    disopyramide


    doxycycline


    efavirenz (this may also affect the blood level of phenytoin)


    eplerenone


    etoposide


    furosemide


    imatinib


    lamotrigine


    methadone


    mexiletine


    mianserin


    midazolam


    mirtazapine


    montelukast


    oestrogens and progestogens such as those in the contraceptive pill (Phenytoin can make these types of contraceptive ineffective, or cause breakthrough bleeding. Women taking phenytoin who need a contraceptive should be prescribed hormonal contraceptives that contain a total of at least 50 micrograms of oestrogen, or use non-hormonal methods of contraception, such as condoms. Discuss this with your doctor.)


    oestrogens and progestogens in HRT (hormone replacement therapy)


    paroxetine
    ستخدم لمرضى الصرع

  3. #3

    افتراضي

    دواء الاول يستخدم لمرضى الصرع وهذا اسمه تجاري الا اعطاك الدكتور

  4. #4

    افتراضي

    اخووووووووي وبعدين ماقلت لنا المريض مصاب بضغط

  5. #5

    افتراضي

    What is Keppra (Levetiracetam)?
    Levetiracetam is an anti-epileptic drug.

    Levetiracetam is used to treat partial onset seizures in people with epilepsy. Levetiracetam is also used to treat myoclonic seizures and tonic-clonic seizures.

    Levetiracetam may also be used for other purposes not listed in this medication guide.

    Generic: Levetiracetam

  6. #6

    افتراضي

    هذا يستخدم لتسجنج يعني المريض لازم يتخدمها مع بعض
    عشان المريض لما يجيه الصرع يجي وراءه التسجنج وهو الدكتور كلامه صحيح وهذه اعراضه الجانبيه بس اهم شئ نعرف انه مافي معه ضغط

  7. #7

    افتراضي

    بعد ما تعب والدي و جاء له التشنج قبل شهر ..

    أصبح والدي مريض ضغط (ضغطه مرتفع) و السكر مرتفع ==>> مع ان والدي ولله الحمد لم يكن معه لا ضغط و لاسكر ..

    بالنسبه للضغط :

    ويستخدم للضغط :

    1/ AMLOR 5 MG ==>> كبسولتين مره واحده في اليوم

    2/ TENORMIN ====>> حبه واحده في اليوم

    وايضا كان كاتب له دواء ضغط : NATRILIX حبه واحده في اليوم

    يعني كانت الثلاثه الادويه هذه مع بعض للضغط بعدين أستبعد NATRILIX لأنه مدر للبول وكنا شاكين انه معاه قصور كلى ولكن الحمد لله طلعت الكلى سليمة و لكن لم نعد نستخدم NATRILIX ..

    -----------------------------------------------------------------

    بالنسبه للسكر :
    الحمد لله لم يعد معه سكر منذ اليوم 3 من التشنج ..

    -------------------------------------------------------------------

    حالة والدي عموما :

    مريض بالزهايمر منذ اكثر من 6 سنوات و يستخدم عدة ادويه :

    1/ Aricept 10 mg ===>> حبة واحده في اليوم
    2/ Gincosan ===>> كبسولتين مره واحده في اليوم ..
    3/ Hydergin 1,5 mg ====>> حبتين مره واحده في اليوم ..

    --------------------------------------------------------------

    وكان يستخدم ايضا :

    1/ Parlodel 2.5 mg ==>> حبة واحده يوميا

    2/ إسبرين للاطفال ==>> حبة واحده يوميا

    ولكن بعد حالة التشنج قال تتوقف و نرجع بعد فتره لها و لكن ليس الان ..

    --------------------------------------------------------------

    وايضا حاليا يستخدم مع أدوية التشنج :

    Rantag 150 mg ==>> حبة واحدة مرتين في اليوم


    ملاحظه : الطبيب يقول انها شبه جلطه وراحت ..

    جزاك الله خيرا ..

  8. #8

    افتراضي

    الحمدالله واسال الله ان يشفى والدك وان يجزاك خير الجزاء على برك لوالدك

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