A 36-year-old woman presented with a history of seizures that began at age 16. Her seizures are described as generalized tonic-clonic. Originally, she received phenobarbital. The tonic-clonic seizures were controlled, but she began to have episodes of non-responsive staring (absence seizure). Her medication was changed to phenytoin (PHT). PHT controlled both the staring episodes and the tonic-clonic seizures, but severe gum hypertrophy occurred. She was changed to carbamazepine, but the episodes of staring became more frequent and she developed involuntary jerking of her upper extremities (myoclonic seizure). For the past 2 years, she had received 500 mg of valproate (VPA) three times per day. She reported no side effects, seizures, or other related events. At age 30, she suffered a miscarriage while taking PHT. She has a 3.5-year-old son. During the pregnancy, she remained seizure free. There was no history of birth defects. She is taking an oral contraceptive and has no other medical conditions. She wishes to conceive in the future. My question is what alternative drugs we can prescribe in point number 1 and 2 that the side effects won't occur? Please answer at your own easy words. Please don't use AI for answering this question.

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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A 36-year-old woman presented with a history of seizures that began at age 16. Her seizures are described as generalized tonic-clonic.

Originally, she received phenobarbital. The tonic-clonic seizures were controlled, but she began to have episodes of non-responsive staring (absence seizure).
Her medication was changed to phenytoin (PHT). PHT controlled both the staring episodes and the tonic-clonic seizures, but severe gum hypertrophy occurred.
She was changed to carbamazepine, but the episodes of staring became more frequent and she developed involuntary jerking of her upper extremities (myoclonic seizure).
For the past 2 years, she had received 500 mg of valproate (VPA) three times per day. She reported no side effects, seizures, or other related events.

At age 30, she suffered a miscarriage while taking PHT. She has a 3.5-year-old son. During the pregnancy, she remained seizure free. There was no history of birth defects. She is taking an oral contraceptive and has no other medical conditions. She wishes to conceive in the future.

My question is what alternative drugs we can prescribe in point number 1 and 2 that the side effects won't occur? Please answer at your own easy words.

Please don't use AI for answering this question.

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