Details About Generic Salt ::  Tiagabin

Main Medicine Class:: Anticonvulsant   

(TIE-egg-un-bine)
Gabitril
Class: Anticonvulsant

 

Drugs Class ::

 Action Mechanism unknown; may block GABA uptake into presynaptic neurons, allowing more GABA to be available for binding with the GABA receptor of post-synaptic cells.

Indications for Drugs ::

 Indications Adjunctive treatment in treatment of partial seizures.

Drug Dose ::

 Route/Dosage

ADOLESCENTS 12–18 YR: PO Initial dose 4 mg qd. Increase dose by 4 mg after 1 week and thereafter by 4–8 mg at weekly intervals until response achieved or total of 32 mg/day. ADULTS: PO Initial dose 4 mg qd. Increase by 4–8 mg at weekly intervals until response achieved or total of 56 mg/day.

Contraindication ::

 Contraindications Standard considerations.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children < 12 yr not established. Hepatic function impairment: Dosage reduction or longer doing interval may be necessaryN Serious adverse effects: During clinical trials some patients experienced status epilepticus, and 10 sudden unexplained deaths occurred. The association of these events with tiagabine use is unclear. Withdrawal: Do not discontinue antiepileptic drugs abruptly because of possible increased seizure frequency on drug withdrawal. EEG: Patients with a history of spike and wave discharges on EEG may have exacerbations of EEG abnormalities associated with cognitive/neuropsychiatric events, which may be a manifestation of underlying seizure activity. Dosage reduction of tiagabine may be necessary.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Dizziness; lightheadedness; somnolence; nervousness; irritability; agitation; ostility; language problem; tremor; abnormal gait; ataxia; abnormal thinking; oncentration/attention difficulty; depression; confusion; insomnia; speech disorder; difficulty with memory; paresthesia; emotional lability. DERM: Rash; pruritus; occhymosis. EENT: Nystagmus; amblyopia; pharyngitis. GI: Nausea; abdominal pain; diarrhea; vomiting; increased appetite; mouth ulceration; gingivitis. OTHER: Asthenia; lack of energy; pain; cough; myasthenia; accidental injury; nfection; flu syndrome; myalgia; urinary tract infection; vasodilation.

Drug Mode of Action ::  

 Action Mechanism unknown; may block GABA uptake into presynaptic neurons, allowing more GABA to be available for binding with the GABA receptor of post-synaptic cells.

Drug Interactions ::

 Interactions

Enzyme-inducing antiepileptic drugs (eg, carbamazepine, phenytoin, primidone, phenobarbital): Increased tiagabine clearance.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note hepatic function impairment and seizure pattern.
  • Assess baseline vital signs.
  • Assess for development of side effects. Notify physician if noted.
  • Withdraw medication gradually to avoid the possibility of increasing seizure frequency.
OVERDOSAGE: SIGNS & SYMPTOMS
  Somnolence, impaired consciousness, agitation, confusion, speech difficulty, hostility, depression, weakness, myoclonus, ataxia, lethargy, drowsiness

Drug Storage/Management ::

 Administration/Storage

  • Administer medication with food.
  • Titrate dose at weekly intervals to effective or maximum dose.
  • Administer initial dose as single daily dose. The total daily dose should be given as equally divided doses 2–4 times a day.
  • Discontinue medication gradually over minimum of 1 wk.
  • Store at room temperature, protected from light and moisture.

Drug Notes ::

 Patient/Family Education

  • Advise patient that medication should be taken with food.
  • Explain that missed dose should be taken as soon as possible but that 2 doses should not be taken together. Instruct patient to call physician if 2 or more doses are missed.
  • Instruct patient to report these symptoms to physician: somnolence, excessive fatigue or weakness, dizziness, concentration or attention difficulty, difficulty with memory, speech disorder, or ataxia.
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
  • Advise patient to use caution when taking these other drugs with CNS depressant effects (eg, alcohol, sedatives, etc).
  • Advise patient to notify their physician if they become pregnant, plan on becoming pregnant or are breastfeeding while taking this medication.

Disclaimer ::

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