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ANTICONVULSANTS PHENYTOIN - rEMERGs

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LAMOTRIGINE<br />

Sedation, ataxia, nystagmus, slurred speech, seizures<br />

ECG abnormalities: QRS prolongation has been seen (uncommon)<br />

Supportive care<br />

Activated charcoal<br />

ECG monitoring<br />

Bicarb for wide QRS (unproven)<br />

Benzodiazepines for seizures<br />

PRESENTATION LEVELS MANAGEMENT<br />

<strong>PHENYTOIN</strong><br />

Nystagmus<br />

Ataxia<br />

Movement disorders<br />

Seizures RARE<br />

40 - 79 umol/L<br />

check albumin level<br />

Supportive<br />

Activated charcoal<br />

CARBEMAZEPINE<br />

Nystagmus<br />

Ataxia<br />

Seizures COMMON<br />

WIDE QRS<br />

WIDE QT<br />

17 - 51 umol/L Cardiac monitoring<br />

MDAC<br />

BICARB<br />

VALPROIC ACID<br />

Coma<br />

Respiratory depression<br />

NO ataxia seizures<br />

347-833 umol/L<br />

Carnitine decreased<br />

Ammonia increased<br />

MDAC<br />

WBI for SR prep<br />

Carnitine<br />

Narcan<br />

Dialysis

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