5. Doctor Patient Communication: Phenytoin for generalized tonic clonic seizures

Summary

In this conversation, a doctor explains to a patient diagnosed with epilepsy the details of their condition and treatment plan. The patient is prescribed a drug called Svenitoine, with instructions on dosage, timing, and potential side effects like double vision and gum thickening. The doctor advises on maintaining oral hygiene, the importance of regular doses, and never stopping the medication abruptly. Special considerations for pregnancy and contraceptive methods are also discussed. The patient is encouraged to keep a seizure diary to track symptoms and assist with medication adjustments.

Takeaways

• 😀 Epilepsy is a condition characterized by short episodes of loss of consciousness and abnormal limb movements due to abnormal brain discharges.
• 😀 The prescribed medication, Svenitoine, should be taken twice daily: once in the morning, once in the afternoon, and once in the evening.
• 😀 To avoid forgetting doses, take the medication at fixed times each day.
• 😀 If a dose is missed, take it as soon as you remember unless too much time has passed, in which case skip it and go for the next dose. Never double the dose.
• 😀 Common side effects of the drug include double vision, dizziness, and long-term complications like gum thickening and facial hair growth.
• 😀 Maintaining proper oral hygiene, such as brushing teeth twice daily, can help manage side effects like gum thickening.
• 😀 If planning for pregnancy, inform the doctor in advance to start folic acid to prevent side effects on the baby.
• 😀 The effectiveness of oral contraceptives may be reduced while taking this medication, so alternative contraceptive methods like condoms are recommended.
• 😀 Do not stop taking the medication abruptly, as it can lead to breakthrough seizures, which can be severe.
• 😀 Keep a seizure diary to track any seizures, even if they occur while taking the medication regularly, for better dose adjustments.

Q & A

What condition has the patient been diagnosed with?

The patient has been diagnosed with epilepsy, which involves short episodes of loss of consciousness and abnormal limb movements due to abnormal discharges from the brain.

What medication has been prescribed to the patient for epilepsy?

The doctor has prescribed a drug called 'Svenitoine' to treat the patient's epilepsy. The patient should take it twice daily, once in the morning, afternoon, and evening.

Why is it important for the patient to take the medication at fixed times each day?

Taking the medication at fixed times every day helps ensure that the patient does not forget to take a dose. This consistent schedule reduces the risk of missing doses.

What should the patient do if they miss a dose of medication?

If the patient forgets a dose, they should take it as soon as they remember. If a significant amount of time has passed, they should skip the missed dose and take the next dose at the regular time. The patient should never take two doses at once.

What are some potential side effects of the medication?

Possible side effects of Svenitoine include double vision, dizziness, gum thickening, and unwanted facial hair growth. However, the patient should not stop taking the drug or alter its dosage without consulting the doctor.

What should the patient do if they experience side effects?

If the patient experiences side effects like gum thickening, they should maintain good oral hygiene, such as brushing their teeth twice a day. If the side effects continue, they should visit the doctor for further adjustments or solutions.

What advice is given if the patient is planning for pregnancy?

If the patient is planning for pregnancy, they should inform the doctor in advance. The doctor will prescribe folic acid to prevent unwanted side effects on the baby. The patient should also continue taking their medication regularly during pregnancy.

What should the patient know about using oral contraceptive pills while on this medication?

Svenitoine can reduce the effectiveness of oral contraceptive pills. If the patient is using them, they should consider additional barrier methods of contraception, such as condoms.

What should the patient do if they feel better and want to stop taking the medication?

The patient should never stop taking the medication without consulting the doctor, even if they feel better. Stopping abruptly can lead to severe breakthrough seizures.

Can the patient buy the medication from their local pharmacy?

Yes, the patient can purchase the medication from their local pharmacy, but they should not change the brand of the drug. Switching brands may affect the drug's effectiveness.

What is the purpose of maintaining a seizure diary?

The patient should maintain a seizure diary to record any seizures they experience despite taking the medication. This will help the doctor adjust the dosage more effectively based on the patient's condition.