(3) Cautions and warnings. Patients who take phenobarbital should be
warned about drowsiness. Patients who take phenobarbital should not drink alcohol
while taking phenobarbital. Dosage of the drug should be reduced by small amounts in
order to avoid hastening convulsions. Lastly, phenobarbital may stimulate the activity of
a number of enzyme systems and affect the metabolism of various drugs (for example,
(1) Clinical uses. Phenytoin is used alone or in combination with
phenobarbital in the treatment of grand mal and psychomotor epilepsy. It is also used
in the treatment of other types of convulsions.
(2) Adverse effects. Adverse effects associated with phenytoin include
ataxia (lack of muscular coordination, staggering walk), nystagmus (a rapid, involuntary
movement of the eyeball), and slurred speech. Drowsiness and fatigue may
accompany these adverse effects in some patients by tremors and nervousness and in
(3) Caution and warning. Drug interactions can occur between phenytoin
and alcohol, barbiturates, folic acid, coumarin-type anticoagulants, disulfirams, the
sulfonamides, and sympathomimetic agents. Phenytoin should be used cautiously with
patients who are alcoholics or who have blood dyscrasias.
(1) Clinic use. Ethosuxamide is the drug of first choice for the treatment of
petit mal epilepsy.
(2) Adverse effects. Drowsiness, ataxia, and gastrointestinal irritation are
adverse effects associated with the use of ethosuxamide.
(3) Caution and warning. Ethosuxamide should be used cautiously with
patients who have blood dyscrasias or liver or kidney impairment.
(1) Clinical uses. Clonazepam is used in the treatment of grand mal
epilepsy. It is the alternate drug for the treatment of petit mal in patients who fail to
respond to ethosuxamide (Zarontin) therapy.
(2) Adverse effects. The primary side effect associated with clonazepam is
central nervous system depression. Drowsiness is frequently seen in patients who take