A 35 years old male presented to a hospital with focal seizures. His renal function was normal. Which of the following is the drug of choice for this patient?
High-Yield Explanation
Carbamazepine and oxcarbazepine (related drug), phenytoin, lamotrigine and topiramate are currently the drugs of choice approved for the initial treatment of paial seizures, including those that secondarily generalize. Overall they have very similar efficacy But differences in pharmacokinetics and toxicity are the main determinants for use in a given patient. An advantage of carbamazepine is that its metabolism follows first-order pharmacokinetics, and the relationship between drug dose, serum levels, and toxicity is linear. Oxcarbazepine Keto analog of carbamazepine Advantage of being metabolized (glucuronide conjugation) in a way that avoids an intermediate metabolite associated with some of the side effects of carbamazepine. Potency of enzyme induction is less Fewer drug interactions than carbamazepine.