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Medical Forum / Diseases and Disorders / Epilepsy / July 2004

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other forms of medication?

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r.p.mcmurphy - 06 Jul 2004 09:56 GMT
hi all, I look after a young lady who has learning disabilities, behavioural
difficulties and epilepsy.  we have  great problem administering the
carbomazepine and sodium valproate meds.  she tends to spit them out and it
not sure that she has taken the right amount.  she will not take tablets
either.

are there any other forms of medication that can be given?  i.e. is there a
patch or injection that could be considered?  her epilepsy is uncontrolled
and we need to look into other possible solutions.

Steve
gaross - 06 Jul 2004 15:36 GMT
 I think there might be a Liquid version of Carbamazepine (Tegretol), but
may be mostly for children.  It might be harder to get the Daily Target Dose
in liquid form, especially if you're having trouble with tablets.  I don't
know if grinding up the tablets of that and valproate reduces its absorption
balance or not.  I think it's absorbed in the LIver or Kidneys so needs to
get past the stomach 'intact' to where it's targeted.   That's why the
tablets are either in Solid Form or Plastic Capsules with powder inside, and
instructions say to Swallow them WHOLE.
   There may be information at the Medications glossary of Ep. Foundation
of America http://efa.org ,  or why not ask the Pharmacist who fills the
prescriptions, what else is listed in their 'scripts'  before speaking to
the Doctor?

  Alternatively, is there any way to explain to her that the Pills, she
doesn't like, are what gives her Control to stop the seizures she has?  She
may not relate the pills she doesn't like, with the Seizures she has since
she's not taking the pills at the right rate?    Carbamazepine, you likely
know, depends on taking a target dose at rate the Dr. has set out.  Skipping
doses or NOT taking it for a longer period after reaching the target dose
can produce MORE  (recoil) seizures if the Doses are **missed too often.  I
don't know if any of that applies to Valproate too or not.

  Note too, with Carbamazepine,  Grapefruit juice can also interfere with
the Dose levels of that med.  Other juices don't have that problem, just one
of the acids in the G.fruit juice.      G./

> hi all, I look after a young lady who has learning disabilities, behavioural
> difficulties and epilepsy.  we have  great problem administering the
[quoted text clipped - 7 lines]
>
> Steve
CyberCafe - 06 Jul 2004 16:34 GMT
> hi all, I look after a young lady who has learning disabilities, behavioural
> difficulties and epilepsy.  we have  great problem administering the
[quoted text clipped - 7 lines]
>
> Steve

www.rxlist.com says Tegretol comes in the following forms:
as chewable tablets of 100 mg, tablets of 200 mg, XR tablets of 100, 200, and
400 mg, and as a suspension of 100 mg/5 ml (teaspoon).

One of the medication web sites says sodium valproate comes in the following
forms:
Crushable tablets (100mg)
Enteric coated tablets (200mg and 500mg)
Modified release tablets (200mg, 300mg and 500mg)
Sugar free oral solution (200mg/5ml)
Syrup (200mg/5ml)
Injection (400mg with a 4ml vial of water for injection for reconstitution)

Ask your pharmacist if tablets can be crushed or capsules emptied and mixed into
a food like applesauce or pudding.  Some capsules are pretty sticky (I think my
Dilantin capsules are terribly sticky), and if you don't take a drink of water
to wet your throat and mouth right before you down them, those capsules will get
stuck on the way down.

http://www.fda.gov/cder has up-to-date drug information.

Barb
cogge' - 06 Jul 2004 19:04 GMT
I believe that topamax and maybe depakote comes in a "sprinkles" form that
you can either mix easily with food or water.  I used to work as a home care
aid for DD adults and we had one gal that was very hard to feed and
administer meds to.  They finally had to put her on a tube feeding program
:-(.

cogge
> hi all, I look after a young lady who has learning disabilities, behavioural
> difficulties and epilepsy.  we have  great problem administering the
[quoted text clipped - 7 lines]
>
> Steve
 
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