Ethosuximide

'Ethosuximide is antiepileptic agent. It was introduced in 1960 as the third of three marketed succinimides. its origin is in the cyclic ureide structure. It has a considerable efficasy against pentylenetetrazol seizures and was introduced as a ''pure petit mal'' drug. its popularity continues, based on its safety and efficasy. its role as the first choice anti-absence drug remains undiminished, in part because of the idiosyncratic hepatotoxicity of the alternative drug, valproic acid. Ethosuximide is administered orally.'

Brands
Adult Dose
Dose: 3.571 to 7.142 mg/kg
Single Dose: 5.4 (5.3565)
Frequency: 24 hourly
Route: PO
Instructions: Initially for a week
Neonatal
Dose: Not indicated in this age group
Single Dose:
Frequency:
Route:
Instructions:
Paedriatic
Dose: 12.5 to 25 mg/kg
Single Dose: 19 (18.75)
Frequency: 12 hourly
Route: Oral
Instructions: Start with low doses, and then Gradually Increase
Characteristics
Ethosuximide also known as Emeside, Emeside. . It is of Synthetic origin and belongs to Pyrrolidinedione. . The Molecular Weight of Ethosuximide is 141.20. Its pKa is 9.3.
Contraindications
Ethosuximide is contraindicated in conditions like Hypersensitivity to any component of product.
Effects
The severe or irreversible adverse effects of Ethosuximide, which give rise to further complications include Erythema multiforme, Systemic lupus erythematosus, Tonic-clonic seizures.Ethosuximide produces potentially life-threatening effects which include Bone marrow suppression. which are responsible for the discontinuation of Ethosuximide therapy.The signs and symptoms that are produced after the acute overdosage of Ethosuximide include Drowsiness, Headache, Lethargy, Dysequilibrium, Unsteadiness.The symptomatic adverse reactions produced by Ethosuximide are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Anorexia, GI symptoms, Hiccups, Abdominal discomfort.
Indications
Ethosuximide is primarily indicated in conditions like Generalised epilepsy with absence seizures, and can also be given in adjunctive therapy as an alternative drug of choice in Myoclonic seizures.
Interactions
Ethosuximide is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholCarbamazepineCarbamazepine possibly reduces plasma concentration of Ethosuximide.MajorDexamphetamine (Sulphate)IprindoleTheoretical potential for ETHOSUXIMIDE increasing the CONVULSANT effect of IPRINDOLE. ModerateIsoniazidIsoniazidLofepramine (HCl)Theoretical potential for ETHOSUXIMIDE increasing the CONVULSANT effect of LOFEPRAMINE. ModeratePhenobarbitonePhenytoin (Na)Sodium ValproateSodium ValproateVORICONAZOLEVoriconazole may increase the serum concentration of ethosuximide by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of ambrisentan if voriconazole is initiated, discontinued or dose changed. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Urinanalysis Liver Function Test (LFT)
Risks
Drug should not be given to Pregnant Mothers, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Caps, Syrup Store in a well closed container, Below 30°C.
Warnings
Ethosuximide should be used with extreme caution in patients with hepatic disease because the drug has been associated with the onset of hepatitis and jaundice. Liver function tests (LFT) should be performed periodically. Ethosuximide should be used with caution in patients with intermittent porphyria because it could exacerbate it. Ethosuximide should be used with extreme caution in patients with renal disease. Urinalysis should be performed regularly, especially in patients at risk. It should be used with caution in patients with blood dyscrasias or any hematological disease. It should be used with caution in patients with a known succinimide hypersensitivity. It should be used with caution during pregnancy. Safe use has not been established. Avoid abrupt discontinuation because abrupt discontinuation of ethosuximide can precipitate seizures. Withdraw drug slowly upon the appearance of unusual depression, aggressiveness or other behavioral alteration.
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