Monday 11 February 2019

Drugs to be avoided in epilepsy and myasthenia Gravis

Drugs to avoid in patients with seizures -

 Although the list of medications that lower seizure threshold is huge, most of these medications cause seizures only in rare occasions. - Example; all cephalosporins have the potential of inducing seizures, however only cefepime was found to be commonly implicated and rest of cephalosporins are rarely associated with seizures. - Here, we included only drugs that known to commonly induce seizures. Group Family Drugs shown to lower seizure threshold Antibiotics 4 th generation cephalosporins Cefepime Carbapenems Imipenem Penicillin Ampicillin – Ampicillin/Sulbactam (Unasyn) Quinolones Ciprofloxacin – Levofloxacin Antipsychotics Atypical antipsychotics Clozapine Typical antipsychotics Chlorpromazine Antidepressants Aminoketones Bupropion Serotonin agonists Buspirone SNRI Venlafaxine Tricyclics Amitriptyline – Nortriptyline – Clomipramine Mood stabilizers Lithium Lithium Analgesics Narcotics Fentanyl – Tramadol – Meperidine Immunosuppressants Calcineurin inhibitor Cyclosporine – Tacrolimus




Drugs to Avoid with Myasthenia Gravis

Antibiotics Heart medications Anesthesia Brain/Nerve Others ampicillin Quinidine Procainamide Lithium Timolol eye drops Amoxicillin Quinine Succinylcholine Phenytoin Cortisones Penicillin Procainamide Curare derivatives Gabapentin Penicillamine Imipenem Statins Botox Iodinated contrast Aztreonam Atenolol Nicotine Magnesium Ofloxacin Metoprolol Methocarbamol Interferon alpha Levofloxacin Sotalol Ciprofloxacin Propranolol Erythromycin Pindolol Clindamycin Nebivolol Azithromycin Nadolol Clarithromycin Labetalol Amikacin Esmolol Gentamycin Carvedilol Tobramycin Bisoprolol Kanamycin Acebutolol Neomycin Amlodipine Streptomycin Verapamil Red: Strong evidence of harmful effect Diltiazem Yellow: Few case reports of harmful effect Nifedipine Blue: Should be avoided in spite of weak clinical evidence Felodipine NB: to make it a patient friendly list, names of all common individual medications were listed instead of pharmacutical group listing so you can 

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