Wednesday, 6 November 2013

keppra

Levetiracetam (INN/lɛvɨtɪˈræsɨtæm/ is ananticonvulsant medication used to treat epilepsy.

Levetiracetam is marketed under the trade nameKeppra.

Levetiracetam has been approved in the European Union as a monotherapy treatment for epilepsy in the case of partial seizures, or as an adjunctive therapy forpartialmyoclonic and tonic-clonic seizures.

Levetiracetam has potential benefits for other psychiatric and neurologic conditions such as Tourette syndromeautismbipolar disorder and anxiety disorder,[3] as well as Alzheimer's disease.

Along with other anticonvulsants like gabapentin, it is also sometimes used to treat neuropathic pain.

Adverse effects

may cause drowsiness, weakness, unsteady gait, fatigue, coordination problems, headache, pain, forgetfulness,anxietyirritability or agitation, dizziness, mood changes, nervousness, loss of appetite, vomiting, diarrhea, throat pain, constipation, and changes in skin pigmentation.
Serious side effects may include depression, hallucinations, suicidal thoughts, seizures that are worse or different, fever, sore throat, signs of infection, double vision, itching, rash, swelling of the face.

Mechanism of action

drug binds to a synaptic vesicle glycoprotein, SV2A,[26] and inhibits presynaptic calcium channels.[27] This is believed to impede impulse conduction across synapses.



Monday, 4 November 2013

case asthma

3 yo m girl.
moderate acute exacerbation of bronchial asthma secondary to acute pharyngitis
with underlying moderate persistent asthma
on mdi salbutamol prn and mdi budesonide 2puff bd
on nebuliser 4hly
on iv augmentin day4

plan
1. keep spo2 >95%
2. change to oral augmentin 300mg bd ( 15 mg perkg bd)
3. mdi salbutamol 6 puff 2hly.
4. complete oral prednisolone 5 days.
5. if discharge tca under tca 2 months under respiratory team


Saturday, 2 November 2013

sedation in paeds

usually we give chlorohydrate first. if ptn still awake then can give domicum.


antibiotics in paeds

bactrim
 used in prophylaxis of uti in 5kg child
give syrup bactrim 220 mg daily for 3 days weekly. (44 mg per kg)

Bactrim contains a combination of sulfamethoxazole and trimethoprim and is supplied in tablets and a liquid suspension. 




Tuesday, 22 October 2013

case simple febrile fit





















asthma note















case asthma


case 1.
moderate axute exacerbation of asthma

plan:
give nebulizer salbutamol 2 hly
give iv hydrocortisone 4mg perkg 6 hly for 1 day then followed by oral steroid


case 2,
mild aeba wt 44kg

plan:
give nebuliser salbutamol 4 hly
start t.prednisolone 20 mg bd(1mg/kg)

pneumonia notes




case acute gastroenteritis